Document Detail


Priming with rocuronium or vecuronium prevents remifentanil-mediated muscle rigidity and difficult ventilation.
MedLine Citation:
PMID:  19685109     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The aim of this study was to test our hypothesis that priming with rocuronium would prevent muscle rigidity and difficult ventilation due to remifentanil administration. METHODS: One hundred patients, American Society of Anesthesiologists (ASA) status I or II, were recruited into the study, and randomly allocated to one of four protocols (n = 25 each). Remifentanil was administered at 0.2 microg.kg(-1).min(-1) in group A and at 0.7 microg.kg(-1).min(-1) in groups B, C, and D. Priming with vecuronium (0.02 mg.kg(-1)) or rocuronium (0.06 mg.kg(-1)) was performed at the same time as the infusion of remifentanil in groups C and D, respectively. Anesthesia was induced with 1 mg.kg(-1)propofol 2 min after the start of remifentanil infusion. After the patient had lost consciousness, the anesthesiologist performed mask ventilation, and watched for the presence of muscle rigidity. Ventilation and rigidity were evaluated using a scoring system. RESULTS: Of the 100 patients, 9 were excluded; the number of patients in group A was 24, while groups B and D had 22 patients each, and group C had 23 patients. A lower dose of remifentanil (group A) or priming with vecuronium or rocuronium (groups C, D) significantly reduced the incidence of some difficulty with ventilation (P = 0.0010, P = 0.0053, and P = 0.021, respectively, vs group B). Of the patients in group B, 10 (45.5%) developed some difficulty with ventilation, and ventilation was impossible in 2 of them. On the other hand, 1 (4.1%) of the patients in group A, 2 (8.7%) in group C, and 3 (13.6%) in group D developed some difficulty with ventilation. CONCLUSION: The present study showed that priming with rocuronium or vecuronium reduced the incidence of difficult ventilation by avoiding the muscle rigidity caused by remifentanil.
Authors:
Junya Nakada; Masao Nishira; Renko Hosoda; Kazumi Funaki; Shyunsaku Takahashi; Tatsuya Matsura; Yoshimi Inagaki
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2009-08-14
Journal Detail:
Title:  Journal of anesthesia     Volume:  23     ISSN:  1438-8359     ISO Abbreviation:  J Anesth     Publication Date:  2009  
Date Detail:
Created Date:  2009-08-17     Completed Date:  2009-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8905667     Medline TA:  J Anesth     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  323-8     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Aichi Cancer Center, 1-1 Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Androstanols*
Anesthesia, Intravenous / adverse effects*
Anesthetics, Intravenous / adverse effects*
Female
Humans
Laryngeal Masks
Male
Middle Aged
Muscle Rigidity / chemically induced*,  prevention & control*
Neuromuscular Nondepolarizing Agents*
Oxygen / blood
Piperidines / adverse effects*
Respiration, Artificial*
Vecuronium Bromide*
Chemical
Reg. No./Substance:
0/Androstanols; 0/Anesthetics, Intravenous; 0/Neuromuscular Nondepolarizing Agents; 0/Piperidines; 132875-61-7/remifentanil; 143558-00-3/rocuronium; 50700-72-6/Vecuronium Bromide; 7782-44-7/Oxygen

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