Clinical Observations on the Neuromuscular Blocking Action of Org 9426, a New Steroidal Non-Depolarizing Agent

Abstract

The neuromuscular blocking effects of Org 9426, the 2-morpholino, 16-allyl-pyrrolidino derivative of the 3-desacetoxy analogue of vecuronium have been investigated in anaesthetized patients. Based on data from a pilot study, two doses, 250 and 500 micrograms kg-1 (estimated as the ED90 and 2 x ED90, respectively) were chosen. Org 9426 appeared to be six to eight times less potent than vecuronium and showed a faster rate of development of neuromuscular block, with good to excellent intubation conditions within 60 s after administration of a dose of 500 micrograms kg-1. The duration of action and the recovery index appeared to be similar to those of vecuronium. Side effects were not noted. Org 9426 may have advantages over existing non-depolarizing neuromuscular blocking agents with respect to rate of development of good intubating conditions, and is stable in aqueous solutions.

Equi-lasting doses of rocuronium, compared to mivacurium, result in improved neuromuscular blockade in patients undergoing gynecological laparoscopy

“…Based upon previously reported data, 6,7 an assumed interval 25-75% of nine minutes with a SD of 3.3, revealed that a group size of 30 would be required to detect a three-minute difference between the two groups with >0.9 power. As our data displayed normal distribution, paired t test was used for the parametric data and MannWhitney U test was used for nonparametric data analysis.…”

“…After T1 baseline stabilization, initial doses of equilasting duration 25% (time from beginning of NMBa administration until 25% T1 recovery) under balanced anesthesia, of either 0.2 mg·kg -1 (3 x ED 95 ) mivacurium expected to last for 21.3 min, 6 or 0.5 mg·kg -1 (1.7 x ED 9 5 ) rocuronium expected to last for 21.2 min, 7 were administered over a period of 30 sec. The trachea was intubated when T1 was suppressed maximally.…”

“…The intubating conditions following rocuronium administration were in accordance with those previously reported using a dose of 0.5 mg·kg -1 , the same as that used in the present study. 7 Three studies used the same dose of 0.2 mg·kg -1 mivacurium as we did while attempting tracheal intubation at different time points from NMBa administration. There was no apparent difference in intubating conditions when intubation was attempted at 1.5 min, 1 2 when it was delayed to two minutes, 1 3 or with a further delay to 2.5 min.…”

Historia de los Bloqueadores Neuromusculares

“…El rocuronio tiene un perfil muy similar al vecuronio, pero en dosis adecuadas logra un tiempo de inicio de acción muy similar al de la succinilcolina. Fue introducido en clínica en Estados Unidos en 1995 y en Chile en 1996 44 .…”

Monitoring, new drugs, and reversal of neuromuscular blocking drugs

“…The ED9s is [25][26][27][28][29][30] Ixg" kg-t. it has a very slow onset to maximum blockade at subparalysing doses (10-13 min). The duration of clinical anaesthesia following 2 x ED95 doses of 90-120 min is similar to pancuronium as is the recovery index (recovery time from 25 to 75% twitch activity) of 30-50 min.…”