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Tempo de latencia e duracao do efeito do brometo de rocuronio no paciente submetido ao transplante renal

Authors: Vianna, Pedro Thadeu Galvão; Takata, I. H.; Braz, José Reinaldo Cerqueira; Castiglia, Yara Marcondes Machado; Ganem, Eliana Marisa; De Carvalho, L. R.;

Tempo de latencia e duracao do efeito do brometo de rocuronio no paciente submetido ao transplante renal

Abstract

Background and Objectives - Successful cadaver kidney transplantation relies on a fast procedure. Patients with chronic renal failure may present with a delayed gastric emptying making it critical a fast tracheal intubation and airway maintenance. Rocuronium a recently introduced nondepolarizing neuromuscular blocker with a fast onset. The aim of this study was to evaluate onset time and duration of rocuronium effects in patients undergoing renal transplantation. Methods - Sixty patients were allocated into two groups of 30: Group R (GR) = patients undergoing renal transplantation and Group N (GN) = patients with normal renal function. All patients were premedicated with oral midazolam (15 mg) and anesthesia was induced with 30 μg.kg-1 alfentanil, 0.3 mg.kg-1 etomidate and 0.6 mg.kg-1 rocuronium injected through a central venous catheter. neuromuscular block was monitored by acceleromyography in the ulnar nerve pathway. The following parameters were evaluated: time between administration of rocuronium and first twitch reduction to 5% after supra-maximal stimulation (T1) (onset time = OT); time for first twitch to return to 25% (clinical duration = R25); time elapsed between 25% and 75% recovery of first twitch (relaxation recovery time = R25-75). Heart rate (HR) and mean blood pressure (MBP) were recorded in 6 moments. Results - Median OT was 31 sec. in GR and 47 sec. in GN. Median R25 was 51.5 min in GR and 33.5 min in GN. Median R25-75 was 28 min in GR and 20 min in GN. MBP and HR were higher in GR. Tracheal intubation conditions were excellent for most patients in both groups. Conclusions - These results open the possibility of 0.6 mg.kg-1 rocuronium being injected through a central venous catheter when a faster onset is needed. Due to wide differences in individual responses, monitoring of neuromuscular block is recommended.

Country
Brazil
Keywords

Monitoring, etomidate, 610, central venous catheter, kidney transplantation, alfentanil, rocuronium, Monitoring, neuromuscular: Acceleromyography, neuromuscular blocking, male, dose response, heart rate, Surgery, Urologic: Renal transplantation, controlled study, human, endotracheal intubation, Nondepolarizing: Rocuronium, anesthesia induction, clinical article, adult, drug effect, neuromuscular: Acceleromyography, anesthesia level, female, Neuromuscular Blockers, midazolam, Neuromuscular Blockers, Nondepolarizing: Rocuronium, anesthetic recovery, Urologic: Renal transplantation, drug blood level, mean arterial pressure, Surgery

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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