The Effect of Priming with Vecuronium and Rocuronium on Young and Elderly Patients

A Study of Priming Technique of Rocuronium in Facilitating Intubation

“…TOF-ratio, 3 minutes after priming was around 0.87, this observation correlates well with the findings of Aziz et al 18 who reported TOF-ratio of around 0.89 in young rocuronium group in a study to investigate the effect of priming with vecuronium and rocuronium on young and elderly patients.…”

Dose preparatória versus injeção única: estudo comparativo entre diferentes doses de cisatracúrio

“…Some authors [14][15][16][17][18] have reported that the priming dose is unable to induce undesirable effects in awaken patients before anesthetic induction, but may, however, uncover their sensitivity to neuromuscular blockers (NMBs). These findings are opposed to those observed in other studies where, although neuromuscular blockers fractional doses allowed for a faster blockade onset as compared to bolus administration, this technique was not risk-free 13,[19][20][21][22][23][24][25][26] . Among priming dose-related side-effects, there are muscle weakness (ptosis, diplopia, difficult swallowing), pulmonary function tests depression, hypoventilation, decreased ability to cough, pulmonary volume decrease and potential oxygenation deterioration, pharyngeal muscles relaxation with a higher risk for gastric content regurgitation [21][22][23][24][25][26][27] .…”

“…These findings are opposed to those observed in other studies where, although neuromuscular blockers fractional doses allowed for a faster blockade onset as compared to bolus administration, this technique was not risk-free 13,[19][20][21][22][23][24][25][26] . Among priming dose-related side-effects, there are muscle weakness (ptosis, diplopia, difficult swallowing), pulmonary function tests depression, hypoventilation, decreased ability to cough, pulmonary volume decrease and potential oxygenation deterioration, pharyngeal muscles relaxation with a higher risk for gastric content regurgitation [21][22][23][24][25][26][27] . Due to partial neuromuscular block after the priming dose, including awaken patients, with a consequent discomfort and respiratory failure evidenced by significant oxygen saturation decrease and severe muscle weakness, monitoring is mandatory 19 .…”

“…Alguns autores 14,18 relataram que a dose preparatória não é capaz de ocasionar efeitos indesejáveis no paciente acordado, antes da indução anestésica, podendo, no entanto, revelar sensibilidade destes aos BNM. Estes achados são contrários aos observados em outros estudos, que relataram que, embora o emprego de doses fracionadas de bloqueadores neuromusculares proporcione instalação mais rápida do bloqueio do que quando a mesma dose é administrada em bolus, esta técnica não é isenta de riscos 13,[19][20][21][22][23][24][25][26] . Entre os efeitos indesejáveis atribuídos a dose preparatória, encontram-se fraqueza muscular (ptose, diplopia, dificuldade de deglutição), depressão dos testes de função pulmonar, hipoventilação, redução da habilidade para tossir, redução do volume pulmonar e potencial deteriorização na oxigenação, relaxamento dos músculos da faringe com maior risco de regurgitação gástrica [21][22][23][24][25][26][27] .…”

A priming technique accelerates onset of neuromuscular blockade at the laryngeal adductor muscles

“…Even if we did not find a significant change in the amplitude of the evoked larynx EMG during the priming interval, priming may cause side effects like hypoventilation, reduced lung volumes and regurgitation and may jeopardize patient safety. 17 Especially in obese, old or somnolent patients the benefits and risks of a priming technique should be evaluated carefully.…”