Comparison between the Effects of Rocuronium, Vecuronium, and Cisatracurium Using Train-of-Four and Clinical Tests in Elderly Patients

Sağır, Özlem; Noyan, Funda Yucesoy; Köroğlu, Ahmet; Çiçek, Müslüm; Toprak, Hüseyin

doi:10.5812/aapm.8406

Cited by 9 publications

(9 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, the metabolism of cisatracurium by Hofmann elimination does not depend on organ function, and thus, any effect on the duration of action is not significantly increased in the elderly [ 7 8 ]. Sagir et al [ 9 ] compared the effects of cisatracurium with those of rocuronium and vecuronium among elderly patients and reported that cisatracurium was suitable for the elderly because it acted quickly. Arain et al [ 10 ] also showed that cisatracurium was appropriate for elderly patients because of its more rapid activation and low variability in the recovery index.…”

Section: Discussionmentioning

confidence: 99%

Effective doses of cisatracurium in the adult and the elderly

Kim

Lee

et al. 2016

Korean J Anesthesiol

View full text Add to dashboard Cite

BackgroundThere are few information about the differences of the effective dose (ED) of cisatracurium between the adult and the elderly. We investigated the ED and the onset time of cisatracurium in the adults and the elderly.MethodsWe studied two hundred patients of the adults aged 20 through 64 years and the elderly aged ≥ 65 years, with American Society of Anesthesiologists physical status I or II. Each 100 patients with 20 patients of each dose group, randomly selected from 30, 40, 50, 60 or 70 µg/kg of cisatracurium, were randomly allocated to the adults and the elderly groups. We recorded the 0.1 Hz single twitch responses of the adductor pollicis and the onset times to maximal blockade. The magnitude of muscle relaxation was recorded by using an acceleromyography. The effect of cisatracurium on single twitch was calculated as percent reduction. After converting each drug dose into logarithm and percent reduction of the muscle reduction into probit, the EDs representing the muscle relaxation effects of 5%, 25%, 50%, 75% and 95% were estimated using the linear regression analysis.ResultsNo significant differences were found in age, weight, height, or body mass index within or between the groups. The ED50 and ED95 of the adult group were 35.39 and 59.58 µg/kg. The ED50 and ED95 of the elderly group were 34.89 and 55.50 µg/kg, respectively. The onset times were 375.4 ± 76.9 seconds in the adult group and 369.1 ± 70.0 seconds in the elderly group.ConclusionsThe ED and the onset time were not significantly different between the adult and the elderly.

show abstract

Section: Discussionmentioning

confidence: 99%

Effective doses of cisatracurium in the adult and the elderly

Kim

Lee

et al. 2016

Korean J Anesthesiol

View full text Add to dashboard Cite

show abstract

“…compared 2ED 95 of R, V and cisatracurium in elderly patients using accelomyography at AP and showed that intubation time was faster with R but cisatracurium had a better recovery profile and hence preferable in elderly. [ 18 ] A study by Somani et al . with 2ED 95 of R and V using TOF guard monitor at AP showed early onset of action in R Group without significant difference in intubation sores.…”

Section: Discussionmentioning

confidence: 99%

Comparison of equipotent doses of rocuronium and vecuronium

2015

View full text Add to dashboard Cite

Background:Rocuronium (R) bromide and vecuronium (V) are monoquaternary aminosteroid compounds. The aim of this study was to evaluate the onset time, conditions of intubation and duration of action of equipotent doses (3ED95) of R and V.Materials and Methods:The study was carried out in 60 adult American Society of Anesthesiologists physical status 1–2 patients of age 20–60 years. The patients were divided into two groups of 30 each and received either 0.9 mg/kg of R (Group R) or 0.168 mg/kg of V (Group V) to facilitate endotracheal intubation. Neuromuscular blockade was assessed at corrugator supercilii and adductor pollicis muscles to evaluate onset time and duration of neuromuscular block, respectively.Results:The mean onset time was significantly rapid in Group R as compared to Group V (P -0.011). Overall intubating conditions were excellent in 100% of patients in Group R as compared to 70% in Group V. The mean duration of action did not show a significant variation between the groups.Conclusion:At equipotent doses, R provides clinically acceptable intubation conditions much earlier than V without significant variation in clinical duration of action.

show abstract

“…Sagir et al 50 directly compared rocuronium, vecuronium, and cisatracurium in elderly patients undergoing abdominal surgery. They concluded that the benzylisoquinolinium compound was safer than the two aminosteroids in the elderly because it performed better in time to positive strength and visual disturbance tests, indicating less risk of residual neuromuscular blockade.…”

Section: Pharmacology Of Nmbas In the Elderlymentioning

confidence: 99%

Neuromuscular blockade in the elderly patient

Lee

Athanassoglou

Pandit

2016

JPR

View full text Add to dashboard Cite

Neuromuscular blockade is a desirable or even essential component of general anesthesia for major surgical operations. As the population continues to age, and more operations are conducted in the elderly, due consideration must be given to neuromuscular blockade in these patients to avoid possible complications. This review considers the pharmacokinetics and pharmacodynamics of neuromuscular blockade that may be altered in the elderly. Compartment distribution, metabolism, and excretion of drugs may vary due to age-related changes in physiology, altering the duration of action with a need for reduced dosage (eg, aminosteroids). Other drugs (atracurium, cisatracurium) have more reliable duration of action and should perhaps be considered for use in the elderly. The range of interpatient variability that neuromuscular blocking drugs may exhibit is then considered and drugs with a narrower range, such as cisatracurium, may produce more predictable, and inherently safer, outcomes. Ultimately, appropriate neuromuscular monitoring should be used to guide the administration of muscle relaxants so that the risk of residual neuromuscular blockade postoperatively can be minimized. The reliability of various monitoring is considered. This paper concludes with a review of the various reversal agents, namely, anticholinesterase drugs and sugammadex, and the alterations in dosing of these that should be considered for the elderly patient.

show abstract

Comparison between the Effects of Rocuronium, Vecuronium, and Cisatracurium Using Train-of-Four and Clinical Tests in Elderly Patients

Cited by 9 publications

References 27 publications

Effective doses of cisatracurium in the adult and the elderly

Effective doses of cisatracurium in the adult and the elderly

Comparison of equipotent doses of rocuronium and vecuronium

Neuromuscular blockade in the elderly patient

Contact Info

Product

Resources

About