Document Detail

Rapacuronium administration to patients receiving phenytoin or carbamazepine.
MedLine Citation:
PMID:  11426100     Owner:  NLM     Status:  MEDLINE    
Patients receiving anticonvulsants such as phenytoin or carbamazepine may be resistant to neuromuscular blocking agents. The authors report the response to rapacuronium bromide (1.5 mg/kg) in two adult patients; one receiving phenytoin and the other receiving carbamazepine. In both patients, there was a delay in achieving maximum blockade; 100% depression of the first twitch was never achieved in the patient receiving phenytoin. Recovery of neuromuscular function was rapid. In the patient receiving phenytoin and carbamazepine respectively, the clinical duration (time to return of T1% to 25% of baseline) was 5 and 9 minutes, the recovery index (T1 25%-75%) was 4 minutes and 3 minutes, and the time to return of T4/T1 to greater than 0.7 was 15 minutes and 18 minutes 40 seconds. As has been reported with other neuromuscular blocking agents of the aminosteroid class, the clinical duration and the recovery index of rapacuronium are shortened in patients receiving either phenytoin or carbamazepine.
J D Tobias; J O Johnson
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of neurosurgical anesthesiology     Volume:  13     ISSN:  0898-4921     ISO Abbreviation:  J Neurosurg Anesthesiol     Publication Date:  2001 Jul 
Date Detail:
Created Date:  2001-06-26     Completed Date:  2001-08-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8910749     Medline TA:  J Neurosurg Anesthesiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  240-2     Citation Subset:  IM    
The Department of Anesthesiology, The University of Missouri, Columbia, Missouri 65212, USA.
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MeSH Terms
Anticonvulsants / therapeutic use
Brain Injuries / complications*
Brain Neoplasms / surgery*
Carbamazepine / therapeutic use*
Drug Interactions
Intracranial Hypertension / etiology,  surgery*
Monitoring, Intraoperative
Neuromuscular Junction / drug effects,  physiology
Neuromuscular Nondepolarizing Agents / therapeutic use*
Phenytoin / therapeutic use*
Synaptic Transmission / drug effects,  physiology
Time Factors
Vecuronium Bromide / analogs & derivatives,  therapeutic use*
Reg. No./Substance:
0/Anticonvulsants; 0/Neuromuscular Nondepolarizing Agents; 0/rapacuronium; 298-46-4/Carbamazepine; 50700-72-6/Vecuronium Bromide; 57-41-0/Phenytoin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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