Efeitos da lidocaína por via venosa sobre a farmacodinâmica do rocurônio

Cardoso, Leandro Sotto Maior; Martins, César; Tardelli, Maria Ângela

doi:10.1590/s0034-70942005000400001

Cited by 17 publications

(11 citation statements)

References 27 publications

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“…É sabido que a duração dos efeitos dos bloqueadores neuromusculares é influenciada por inúmeros fatores, tais como alterações de temperatura, equilíbrio ácido-básico e fármacos, entre os quais, com particular interesse, encontram-se os agentes voláteis, resultando em prolongada recuperação do bloqueio neuromuscular, com conseqüente redução do consumo dos bloqueadores, mesmo quando empregados em pequenas concentrações 3,7,21-26 . Sabe-se que a temperatura da pele abaixo de 32°C diminui a amplitude da resposta muscular evocada e o aumento da temperatura diminui a impedância do eletrodo, superestimando ou subestimando, respectivamente, o bloqueio neuromuscular 26,27 . Alterações ventilatórias com conseqüente acidose ou alcalose respiratória podem também modificar os efeitos dos bloqueadores neuromusculares, aumentando ou diminuindo o bloqueio neuromuscular 23,26 .…”

Section: Discussionunclassified

“…Sabe-se que a temperatura da pele abaixo de 32°C diminui a amplitude da resposta muscular evocada e o aumento da temperatura diminui a impedância do eletrodo, superestimando ou subestimando, respectivamente, o bloqueio neuromuscular 26,27 . Alterações ventilatórias com conseqüente acidose ou alcalose respiratória podem também modificar os efeitos dos bloqueadores neuromusculares, aumentando ou diminuindo o bloqueio neuromuscular 23,26 . Neste estudo, a temperatura da pele do músculo monitorizado e a concentração de CO 2 ao final da expiração foram continuamente monitorizadas e mantidas próximos de 33,6°C e 34 mmHg, respectivamente, o que permite descartar a influência desses fatores nos resultados observados.…”

Section: Discussionunclassified

“…It is known that the duration of action of neuromuscular blockers is affected by several factors, such as changes in temperature, acid-base balance, and drugs, among which volatile anesthetics should be mentioned because they prolong recovery from the neuromuscular blockade even with low concentration leading, consequently, to a reduction in the consumption of those drugs 3,7,21-26 . It is known that skin temperature below 32°C decreases the amplitude of the evoked muscular response, while an increase in temperature decreases electrode impedance, overestimating or underestimating, respectively, the neuromuscular blockade 26,27 . Ventilatory changes and the resulting respiratory acidosis or alkalosis can also affect the response to neuromuscular blockers, increasing or reducing the blockade 23,26 .…”

Section: Discussionmentioning

confidence: 99%

“…It is known that skin temperature below 32°C decreases the amplitude of the evoked muscular response, while an increase in temperature decreases electrode impedance, overestimating or underestimating, respectively, the neuromuscular blockade 26,27 . Ventilatory changes and the resulting respiratory acidosis or alkalosis can also affect the response to neuromuscular blockers, increasing or reducing the blockade 23,26 . In the present study, the temperature of the skin above the muscle and end-expiratory CO 2 concentration were monitored continuously and maintained around 33.6°C and 34 mmHG, respectively, and therefore one can rule out their influence on the results.…”

Section: Discussionmentioning

confidence: 99%

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Efeitos neuromusculares e cardiovasculares do pipecurônio: estudo comparativo entre diferentes doses

Braga¹,

Yoshioka²,

Braga³

et al. 2008

Rev. Bras. Anestesiol.

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BACKGROUND AND OBJECTIVES:Pipecuronium is a non-depolarizing neuromuscular blocker with similar properties to pancuronium, but without cardiovascular effects. Neuromuscular effects, conditions of tracheal intubation, and hemodynamic repercussions of two different doses of pipecuronium were evaluated. METHOD:Patients were divided into two groups according to the dose of pipecuronium: Group I (0.04 mg.kg -1 ) and Group II (0.05 mg.kg -1 ). Intramuscular midazolam (0.1 mg.kg -1 ) was administered 30 minutes before the surgery. Propofol (2.5 mg.kg -1 ), preceded by fentanyl (5 µg.kg -1 ) and pipecuronium (0.04 and 0.05 mg.kg -1 for Groups I and II, respectively), was administered for anesthetic induction. Patients were ventilated with 100% oxygen via a face mask until a 75% reduction in the amplitude of the response to an isolated stimulus (1 Hz) is achieved, at which time laryngoscopy and intubation were carried out. Anesthetic maintenance was achieved with isoflurane (0.5 to 1%) with a mixture of 50% O 2 and N 2 O. Mechanical ventilation was used to maintain P ET CO 2 between 32 and 36 mmHg. The pharmacodynamics of pipecuronium was evaluated by acceleromyography. RESULTS:Mean times and standard deviation for the onset of action, clinical duration (T1 25% ), and recovery index (T1 25-75% ) were: Group I (122.10 ± 4.18 sec, 49.63 ± 9.54 min, and 48.21 ± 6.72 min), and Group II (95.78 ± 8.91 sec, 64.84 ± 13.13 min, and 48.52 ± 4.95 min). Onset of action, clinical duration, and conditions of tracheal intubation were significantly different for both groups.CONCLUSIONS: Pipecuronium at a dose of 0.05 mg.kg -1 can be used in prolonged procedures in which cardiovascular changes should be avoided.

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Section: Discussionunclassified

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Efeitos neuromusculares e cardiovasculares do pipecurônio: estudo comparativo entre diferentes doses

Braga¹,

Yoshioka²,

Braga³

et al. 2008

Rev. Bras. Anestesiol.

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“…Among these drugs are local anesthetics, volatile anesthetic agents, antibiotics aminoglycosides, anticonvulsants, antiarrhythmic, magnesium, lithium, calcium channel blockers and others [1][2][3][4][5][6][7][8][9][10][11][12] . Although countless studies have been accomplished to investigate anticonvulsants effects in the neuromuscular transmission and its interaction with neuromuscular blocking, the results are contradictory [6][7][8][9][10][11][12][13][14][15] .…”

Section: Introductionmentioning

confidence: 99%

Phenobarbital influence on neuromuscular block produced by rocuronium in rats

et al. 2008

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Purpose:To evaluate in vitro and in vivo neuromuscular blockade produced by rocuronium in rats treated with Phenobarbital and to determine cytochrome P450 and cytochrome b5 concentrations in hepatic microsomes. Methods: Thirty rats were included in the study and distributed into 6 groups of 5 animals each. Rats were treated for seven days with phenobarbital (20 mg/kg) and the following parameters were evaluated: 1) the amplitude of muscle response in the preparation of rats exposed to phenobarbital; 2) rocuronium effect on rat preparation exposed or not to phenobarbital; 3) concentrations of cytochrome P450 and cytochrome b5 in hepatic microsomes isolated from rats exposed or not to phenobarbital. The concentration and dose of rocuronium used in vitro and in vivo experiments were 4 µg/mL and 0,6 mg/kg, respectively. Results: Phenobarbital in vitro and in vivo did not alter the amplitude of muscle response. The neuromuscular blockade in vitro produced by rocuronium was significantly different (p=0.019) between exposed (20%) and not exposed (60%) rats; the blockade in vivo was significantly greater (p=0.0081) in treated rats (93.4%). The enzymatic concentrations were significantly greater in rats exposed to phenobarbital. Conclusions: Phenobarbital alone did not compromise neuromuscular transmission. It produced enzymatic induction, and neuromuscular blockade in vivo produced by rocuronium was potentiated by phenobarbital. Key words: Phenobarbital. Neuromuscular Blocking Agents. Rats. RESUMO Objetivo:Avaliar in vitro e in vivo o bloqueio neuromuscular produzido pelo rocurônio em ratos tratados com fenobarbital e determinar as concentrações de citocromo P450 e b5 em microssomos hepáticos. Métodos: Trinta ratos foram incluídos no estudo e distribuídos em seis grupos de cinco animais cada. Ratos foram tratados por sete dias com fenobarbital (20 mg/kg) e avaliou-se: 1) amplitude das respostas musculares em preparação de ratos expostos ao fenobarbital; 2) o efeito do rocurônio em preparações de ratos expostos ou não ao fenobarbital; 3) as concentrações de citocromo P450 e b5 em microssomos isolados de fígados dos ratos expostos ou não ao fenobarbital. A concentração e dose de rocurônio utilizadas nos experimentos in vitro e in vivo foram respectivamente de 4 µg/mL e 0,6 mg/kg. Resultados: In vitro e in vivo, o fenobarbital não alterou a amplitude das respostas musculares. In vitro, o bloqueio produzido pelo rocurônio foi significativamente diferente (p=0.019) entre expostos (20%) e não expostos (60%); in vivo o bloqueio foi significativamente maior (p=0.0081) nos ratos tratados (93,4%). As concentrações enzimáticas foram significativamente maiores nos ratos expostos ao fenobarbital. Conclusões: O fenobarbital isoladamente não comprometeu a transmissão neuromuscular. Ocasionou indução enzimática, e in vivo o bloqueio com o rocurônio foi potencializado pelo fenobarbital.

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Efeito da associação ropivacaina‐pancurônio na transmissão neuromuscular e eficácia da neostigmine e 4‐aminopiridina na reversão do bloqueio: estudo experimental

Braga

Carvalho

Braga

et al. 2015

Brazilian Journal of Anesthesiology

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Efeitos da lidocaína por via venosa sobre a farmacodinâmica do rocurônio

Abstract: Lidocaine associated to rocuronium has prolonged early blockade recovery stage without interfering with onset or late recovery stage.

Cited by 17 publications

References 27 publications

Efeitos neuromusculares e cardiovasculares do pipecurônio: estudo comparativo entre diferentes doses

Efeitos neuromusculares e cardiovasculares do pipecurônio: estudo comparativo entre diferentes doses

Phenobarbital influence on neuromuscular block produced by rocuronium in rats

Efeito da associação ropivacaina‐pancurônio na transmissão neuromuscular e eficácia da neostigmine e 4‐aminopiridina na reversão do bloqueio: estudo experimental

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