Incidence and duration of residual paralysis at the end of surgery after multiple administrations of cisatracurium and rocuronium

Maybauer, Dirk M.; Geldner, Götz; Blobner, Manfred; Pühringer, F. K.; Hofmockel, R.; Rex, Christopher S.; Wulf, Hinnerk; Eberhart, Leopold; Arndt, Christian; Eikermann, Matthias

doi:10.1111/j.1365-2044.2006.04862.x

Cited by 118 publications

(62 citation statements)

References 23 publications

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“…(25) çalışmasında da sisatraküryum ve roküronyumun yineleyen uygulamalarından sonra cerrahi sonunda rezidüel paralizi insidansı roküronyum grubunda anlamlı olarak düşük bulunmasına rağmen, cilt kapatılması ile ekstü-basyon arasındaki süre ve son doz uygulanmasından TOF oranının > 0,9 olmasına kadar geçen süre sisatraküryuma göre anlamlı olarak uzun bulunmuştur. Çalış-mamızda ekstübasyon sırasındaki ortalama TOF değerleri roküronyum grubunda atraküryum grubuna göre anlamlı olarak düşük olmakla birlikte, TOF oranı > 0,7 ve > 0,9 olması için geçen ortalama süre ve cilt kapatılması ile ekstübasyon arasında-ki süre her iki grup için benzer bulunmuş-tur.…”

Section: Discussionunclassified

Postoperative Residual Curarisation After Rocuronium and Atracurium

Işıl¹,

Sivrikaya²,

Erol³

et al. 2011

J Turk Anaesth Int Care

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ÖZETAmaç: Çalışmamızda, roküronyum ve atraküryum kullanımında, neostigminle antagonizasyon ve klinik gözlem ile ekstübasyon sonrası rezidüel kürarizasyonu karşılaştırmayı amaçladık.Gereç ve Yöntem: Elektif abdominal histerektomi operasyonu planlanan ASA I-II grubundan 65 olgu randomize olarak roküronyum 0.6 mg kg -1 (Grup R) veya atraküryum 0.5 mg kg -1 (Grup A) gruplarına dahil edildi. Operasyon bitiminde tüm olgularda neostigminle antagonizasyon ve klinik gözlem kriterlerine göre ekstübasyon yapıldı. TOF değerleri, ekstübasyonda ve sonrasında 1., 3., 5. ve 10. dk.'larda, operasyon ve anestezi süreleri; toplam fentanil, kas gevşetici ve neostigmin dozları kaydedildi.Bulgular: Demografik özellikler; operasyon ve anestezi süreleri; kullanılan toplam fentanil ve neostigmin dozu iki grupta benzerdi. Klinik gözleme göre ekstübe edilen olguların hepsinde ekstübasyon TOF oranı < 0.7 bulundu. Grup R'de TOF değeri Grup A'ya göre ekstübasyonda ve ekstübasyon sonrası 1. ve 3. dk. anlamlı olarak düşük (p<0.05) olmakla birlikte, diğer ölçüm zamanlarında aralarında anlamlı fark bulunmadı. Tüm olgularda TOF≥0.7 ve ≥0.9 değerleri sırasıyla ekstübasyon sonrası 5. ve 10. dk. olarak tespit edildi.Sonuç: Çalışmamızda TOF monitorizasyonunun rezidüel kürarizasyonu tesbit etmede ve önlemede yararlı bir yön-tem olduğu ve neostigminle antagonizasyon sonrası rezidüel blok sıklığının roküronyum veya atraküryumla benzer olduğu sonucuna varıldı. Anahtar kelimeler:Nöromusküler blok, monitorizasyon, rezidüel kürarizasyon, roküronyum, atraküryum SUMMARY Postoperative Residual Curarisation After Rocuronium and AtracuriumObjective: In our study we aimed to compare the occurrence of residual curarization after extubation based on clinical observation with antagonization using neostigmine in patients randomized into rocuronium or atracurium groups.Material and Method: Sixty five patients in physical status ASA I-II group undergoing abdominal hysterectomy were randomly assigned to two groups as rocuronium 0.6 mg kg -1 (Group R) or atracurium 0.5 mg kg -1 (Group A). At the end of the operation all patients were antagonized with neostigmine, and extubated according to clinical extubation criteria. TOF values at the time of extubation and at 1., 3., 5., 10. minutes after extubation, duration of operation and anaesthesia, total fentanyl, neuromuscular blocker agent, and neostigmine doses were recorded.Results: Demographic characteristics of the patients, duration of operation and anaesthesia, total fentanyl, neuromuscular blocker, and neostigmine doses were similar in two groups. TOF ratio at the time extubation was <0.7 in all patients extubated according to clinical observation criteria . Although TOF ratio was significantly lower in Group R compared to Group A at the time of extubation and 1., 3. min after extubation (p<0.05), there were no significant differences at the other time intervals. In all patients time to a TOF ratio of ≥0.7 and ≥0.9 were 5. min and 10. min respectively in patients extubated based on clinical observation.Conclusion: In o...

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Section: Discussionunclassified

Postoperative Residual Curarisation After Rocuronium and Atracurium

Işıl¹,

Sivrikaya²,

Erol³

et al. 2011

J Turk Anaesth Int Care

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“…La incidencia de BNMR presenta una gran variabilidad con porcentajes que oscilan entre el 2% y el 64% 87,93,94,95,96,97,98,99,100,101,102,103,104,105 .…”

Section: Incidencia De Bnmrunclassified

Monitorización intraoperatoria del bloqueo neuromuscular y la presión arterial con un solo dispositivo (TOF-Cuff): estudio comparativo con la mecanomiografía y la presión arterial invasiva

Ruiz

Cayuela

Montes

et al. 2017

Revista Española de Anestesiología y Reanimación

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“…On the basis of previous publications, we defined a priori the following variables that might influence the variance in duration of action of cisatracurium and rocuronium: weight, 15,16 age, 17 sex, 18 ASA score, 19 blood loss, 20,21 lowest core body temperature, 22 duration of NBD administration, 23 and history of tobacco smoking. [24][25][26] Variables that correlated significantly (P = .15) with the mean dur 25 were included in our multiple regression analysis model, and an association of variables with the dur 25 of the respective NBD was assumed at a significance level of less than .05.…”

Section: Discussionmentioning

confidence: 99%

“…Both of these NBDs are often used in anesthesia and intensive care medicine. 4 On the basis of published data, we thought that weight, 15,16 age, 17 sex, 18 American Society of Anesthesiologists (ASA) risk score, 19 blood loss (suggesting instability of cardiac output), 20,21 lowest core body temperature, 22 duration of NBD administration, 23 and tobacco smoking history [24][25][26] might contribute to the variance in the mean duration of action of cisatracurium and rocuronium.…”

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confidence: 99%

Clinical Predictors of Duration of Action of Cisatracurium and Rocuronium Administered Long-Term

Faßbender

Geldner

Blobner

et al. 2009

American Journal of Critical Care

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BackgroundThe duration of action of neuromuscular blocking drugs (NBDs) varies between individuals and even within individuals in different settings. Objectives To define predictors of variance in duration of action of rocuronium and cisatracurium administered long-term. Methods A prospective, double-blind, multicenter trial that included 113 patients scheduled for major abdominal surgery and postoperative admission to the intensive care unit. Patients received repetitive (median, 7) equipotent doses of rocuronium or cisatracurium to maintain deep relaxation (twitch height of the adductor pollicis muscle <25% of baseline). Effects of weight, age, sex, American Society of Anesthesiologists risk score, lowest core temperature, duration of NBD administration, and tobacco smoking history on duration of action of cisatracurium and rocuronium were determined via multiple regression analysis. Results Only duration of NBD administration was predictive of the duration of action of rocuronium. The predicted increase in time to recovery of the train-of-4 ratio to 0.9 (duration TOF 0.9) per hour of continuous NBD treatment was 12.4 minutes. In contrast, only lowest core body temperature was predictive of cisatracurium's duration of action, and the predicted in crease in duration TOF 0.9 per degree Celsius decrease was 9.8 min. Conclusion Duration of NBD treatment is strongly predictive of the duration of action of rocuronium, and body temperature is predictive of the duration of action of cisatracurium. These data may help decrease the incidence of drug-induced muscle weakness in recovery rooms and surgical intensive care units, particularly if neuromuscular transmission monitoring is not available.

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Incidence and duration of residual paralysis at the end of surgery after multiple administrations of cisatracurium and rocuronium

Cited by 118 publications

References 23 publications

Postoperative Residual Curarisation After Rocuronium and Atracurium

Postoperative Residual Curarisation After Rocuronium and Atracurium

Monitorización intraoperatoria del bloqueo neuromuscular y la presión arterial con un solo dispositivo (TOF-Cuff): estudio comparativo con la mecanomiografía y la presión arterial invasiva

Clinical Predictors of Duration of Action of Cisatracurium and Rocuronium Administered Long-Term

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