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Article: The effect of cisatracurium and rocuronium on cisatracurium precurarization and the priming principle

TitleThe effect of cisatracurium and rocuronium on cisatracurium precurarization and the priming principle
Authors
Issue Date2004
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jclinane
Citation
Journal Of Clinical Anesthesia, 2004, v. 16 n. 2, p. 83-87 How to Cite?
AbstractStudy objective To demonstrate the effect of administering a precurarizing dose of cisatracurium or rocuronium on the speed of onset of cisatracurium, and to review the possible mechanisms and value of the priming principle. Design Double-blind, randomized, controlled trial. Setting Inpatient anesthesia in a university teaching hospital. Patients 90 ASA physical status I and II patients undergoing elective surgery requiring endotracheal intubation. Interventions Three groups of 30 patients each were investigated. Following induction of anesthesia with fentanyl and propofol, Group 1 received cisatracurium 0.015 mg.k-1, Group 2 received rocuronium 0.09 mg·kg-1, and Group 3 (control) received normal saline. Six minutes after priming, Groups 1 and 2 received cisatracurium 0.135 mg·kg-1 whereas Group 3 received cisatracurium 0.15 mg·kg-1. Measurements and main results In each group, first twitch height and the train-of-four ratios were recorded every 10 seconds after the initial priming dose. Intubation was attempted after the first twitch height became less than 15% of baseline. The decrease in the train-of-four ratios at 6 minutes was 0.97 for cisatracurium and 0.85 for rocuronium. The onset of muscle relaxation was significantly faster after priming with cisatracurium and rocuronium (71.7 ± 21.3 and 65 ± 19.8 sec, respectively) compared with control (148.7 ± 43.1 sec). Females receiving both muscle relaxants had a faster onset of paralysis than did males (65.9 ± 20.6 vs. 79.2 ± 20.6 and 55 ± 14.5 vs. 71.7 ± 20.4 sec). Intubation conditions were either excellent or satisfactory in all patients. Conclusions Six minutes after precurarization, there is no significant difference between rocuronium and cisatracurium when used as priming drugs. An even faster onset time with both drugs was demonstrated in females. The use of priming doses of 25% to 30% of ED 95 may cause symptomatic muscle weakness. The mechanisms of the priming principle are discussed. © 2004 by Elsevier Inc.
Persistent Identifierhttp://hdl.handle.net/10722/145531
ISSN
2015 Impact Factor: 1.284
2015 SCImago Journal Rankings: 0.431
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorMak, PHKen_HK
dc.contributor.authorIrwin, MGen_HK
dc.date.accessioned2012-02-28T01:53:15Z-
dc.date.available2012-02-28T01:53:15Z-
dc.date.issued2004en_HK
dc.identifier.citationJournal Of Clinical Anesthesia, 2004, v. 16 n. 2, p. 83-87en_HK
dc.identifier.issn0952-8180en_HK
dc.identifier.urihttp://hdl.handle.net/10722/145531-
dc.description.abstractStudy objective To demonstrate the effect of administering a precurarizing dose of cisatracurium or rocuronium on the speed of onset of cisatracurium, and to review the possible mechanisms and value of the priming principle. Design Double-blind, randomized, controlled trial. Setting Inpatient anesthesia in a university teaching hospital. Patients 90 ASA physical status I and II patients undergoing elective surgery requiring endotracheal intubation. Interventions Three groups of 30 patients each were investigated. Following induction of anesthesia with fentanyl and propofol, Group 1 received cisatracurium 0.015 mg.k-1, Group 2 received rocuronium 0.09 mg·kg-1, and Group 3 (control) received normal saline. Six minutes after priming, Groups 1 and 2 received cisatracurium 0.135 mg·kg-1 whereas Group 3 received cisatracurium 0.15 mg·kg-1. Measurements and main results In each group, first twitch height and the train-of-four ratios were recorded every 10 seconds after the initial priming dose. Intubation was attempted after the first twitch height became less than 15% of baseline. The decrease in the train-of-four ratios at 6 minutes was 0.97 for cisatracurium and 0.85 for rocuronium. The onset of muscle relaxation was significantly faster after priming with cisatracurium and rocuronium (71.7 ± 21.3 and 65 ± 19.8 sec, respectively) compared with control (148.7 ± 43.1 sec). Females receiving both muscle relaxants had a faster onset of paralysis than did males (65.9 ± 20.6 vs. 79.2 ± 20.6 and 55 ± 14.5 vs. 71.7 ± 20.4 sec). Intubation conditions were either excellent or satisfactory in all patients. Conclusions Six minutes after precurarization, there is no significant difference between rocuronium and cisatracurium when used as priming drugs. An even faster onset time with both drugs was demonstrated in females. The use of priming doses of 25% to 30% of ED 95 may cause symptomatic muscle weakness. The mechanisms of the priming principle are discussed. © 2004 by Elsevier Inc.en_HK
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jclinaneen_HK
dc.relation.ispartofJournal of Clinical Anesthesiaen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAndrostanols - administration & dosageen_HK
dc.subject.meshAnesthesia, Generalen_HK
dc.subject.meshAtracurium - administration & dosage - analogs & derivativesen_HK
dc.subject.meshDouble-Blind Methoden_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshIntubation, Intratrachealen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMuscle Relaxation - drug effectsen_HK
dc.subject.meshNeuromuscular Blockadeen_HK
dc.subject.meshNeuromuscular Blocking Agents - administration & dosageen_HK
dc.subject.meshNeuromuscular Nondepolarizing Agents - administration & dosageen_HK
dc.subject.meshSex Characteristicsen_HK
dc.subject.meshTime Factorsen_HK
dc.titleThe effect of cisatracurium and rocuronium on cisatracurium precurarization and the priming principleen_HK
dc.typeArticleen_HK
dc.identifier.emailIrwin, MG:mgirwin@hku.hken_HK
dc.identifier.authorityIrwin, MG=rp00390en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.jclinane.2003.05.004en_HK
dc.identifier.pmid15110367-
dc.identifier.scopuseid_2-s2.0-2142822813en_HK
dc.identifier.hkuros89742en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-2142822813&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume16en_HK
dc.identifier.issue2en_HK
dc.identifier.spage83en_HK
dc.identifier.epage87en_HK
dc.identifier.isiWOS:000221277500002-
dc.publisher.placeUnited Statesen_HK

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