Neuromuscular effects of rapacuronium in pediatric patients during nitrous oxide-halothane anesthesia: comparison with mivacurium

Brandom, Barbara W.; Margolis, Judith O.; Bikhazi, George B.; Ross, Allison Kinder; Ginsberg, Brian; Dear, GdeL; Kenaan, Charbel A.; Eck, John B.; Woelfel, S. K.; Lloyd, Mark

doi:10.1007/bf03018850

“…Following anaesthesia with thiopental and fentanyl, the minimum doses of rapacuronium for satisfactory intubation conditions at 60 s were 1.5 and 2.0 mg kg À1 , respectively (%2-3 Â ED 95 ) in infants and children [33,34]. A dose of 2 mg kg À1 produces maximum block in 1.5-2.0 min followed by recovery of T 1 to 25% and 90% in 14-19 and 23-41 min, respectively, in infants and children (Table 2) [30]. Recovery from rapacuronium-induced block is age dependent and slower than that produced by mivacurium [30,33].…”

Section: Rapacuroniummentioning

confidence: 98%

“…Rapacuronium, is a monoquaternary aminosteroidal muscle relaxant characterized by a rapid onset and a short duration of action, suggesting a possible use in paediatric day case surgery [30]. It is metabolized in the liver primarily to a 3-hydroxy metabolite (Org 9488), which itself is a neuromuscular blocking drug, having twice the potency of rapacuronium (biophase EC 50 0.4 Â rapacuronium) and an intermediate to long duration of action [31].…”

Section: Rapacuroniummentioning

confidence: 99%

Muscle relaxants in paediatric day case surgery

Meakin¹

2001

European Journal of Anaesthesiology

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It has been estimated that more than 60% of all paediatric surgery is performed on a day case basis. The benefits of this type of surgery in children include reduced costs, avoidance of the stress of hospitalization and less disruption to family life. The growth of day surgery in children has been facilitated by the development of non-depolarizing neuromuscular blocking agents characterized by short and intermedi-ate duration of action and fewer side-effects. The more rapid onset and shorter duration of action of nondepolarizing neuromuscular blocking agents in children should facilitate the use of these agents in place of succinylcholine for day case procedures.

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“…Rapacuronium is the first non-depolarizing relaxant combining both, rapid onset and short duration of action [6,[19][20][21][22]. Maximum block was achieved in 86 AE 7 s at the vocal cords and in 97 AE 4 s at the adductor pollicis, respectively, after administering a dose of 1.5 mg kg À1 [23].…”

Section: Rapacuroniummentioning

confidence: 99%

Muscle relaxants suitable for day case surgery

Geldner¹,

Wulf²

2001

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Neuromuscular blocking agents are used as adjuvants in day case anaesthesia to facilitate tracheal intubation and/or surgery. Although the majority of day case procedures are performed without the use of neuromuscular blocking agents, there are procedures, such as laparoscopic surgery, microsurgery, open eye surgery, some ear, nose and throat procedures and some paediatric procedures, which may require neuromuscular blockade. The characteristics of an ideal neuromuscular blocking agent for day case surgery are a short onset, a short clinical duration and a short recovery time, with or without reversal. It should also lack histamine release, provide haemodynamic stability, and be competitively priced. This paper reviews the neuromuscular blocking agents currently available and used, such as succinylcholine and mivacurium, low doses of an intermediate-acting neuromuscular block, such as rocuronium and the recently introduced rapacuronium. Their advantages and disadvantages are described and discussed, with special reference to the needs of day case surgery. Rapacuronium offers certain benefits compared with the currently available neuromuscular blocking agents for day care anaesthesia.

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“…Rapacuronium is the first non-depolarizing relaxant combining both, rapid onset and short duration of action [6,[19][20][21][22]. Maximum block was achieved in 86 AE 7 s at the vocal cords and in 97 AE 4 s at the adductor pollicis, respectively, after administering a dose of 1.5 mg kg À1 [23].…”

Section: Rapacuroniummentioning

confidence: 99%

Muscle relaxants suitable for day case surgery

Geldner

¹

,

Wulf

²

2001

European Journal of Anaesthesiology

View full text Add to dashboard Cite

Neuromuscular blocking agents are used as adjuvants in day case anaesthesia to facilitate tracheal intubation and/or surgery. Although the majority of day case procedures are performed without the use of neuromuscular blocking agents, there are procedures, such as laparoscopic surgery, microsurgery, open eye surgery, some ear, nose and throat procedures and some paediatric procedures, which may require neuromuscular blockade. The characteristics of an ideal neuromuscular blocking agent for day case surgery are a short onset, a short clinical duration and a short recovery time, with or without reversal. It should also lack histamine release, provide haemodynamic stability, and be competitively priced. This paper reviews the neuromuscular blocking agents currently available and used, such as succinylcholine and mivacurium, low doses of an intermediate-acting neuromuscular block, such as rocuronium and the recently introduced rapacuronium. Their advantages and disadvantages are described and discussed, with special reference to the needs of day case surgery. Rapacuronium offers certain benefits compared with the currently available neuromuscular blocking agents for day care anaesthesia.

show abstract

Neuromuscular effects of rapacuronium in pediatric patients during nitrous oxide-halothane anesthesia: comparison with mivacurium

Cited by 19 publications

References 22 publications

Muscle relaxants in paediatric day case surgery

Muscle relaxants in paediatric day case surgery

Muscle relaxants suitable for day case surgery

Muscle relaxants suitable for day case surgery

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