Selection of neuromuscular blocking agents in patients undergoing renal transplantation under general anesthesia / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To study the pharmacodynamics of vecuronium,atracurium, mivacurium and rocuronium in patients with end-stage renal failure.</p><p><b>METHODS</b>Forty-six patients with end-stage renal failure scheduled for renal transplantation and 53 patients with normal renal function were given either vecuronium, atracurium, mivacurium or rocuronium. The neuromuscular effects were monitored by the evoked response of the adductor pollicis to train-of-four stimulation of the ulnar nerve.</p><p><b>RESULTS</b>Onset of vecuronium, atracurium and mivacurium occurred faster or tended to be faster in patients with end-stage renal failure, but there was no significant difference in onset by rocuronium between the control patients and renal failure patients. Furthermore, the no-response period, duration of action and recovery of atracurium did not differ between the two groups. There was no significant difference in duration of action or recovery of mivacurium between the two groups, whereas its no-response period was significantly prolonged in the patients with end-stage renal failure. There was no difference in no-response period or duration of action after the initial dose of vecuronium or rocuronium between the two groups. However, no-response period and duration of effect by vecuronium and rocuronium were prolonged with increasing incremental doses in patients with end-stage renal failure.</p><p><b>CONCLUSIONS</b>All four muscle relaxants could be safely used in patients with end-stage renal failure. Onset of the relaxants were, in some cases, accelerated and no-response period of mivacurium was prolonged in patients with end-stage renal failure undergoing dialysis therapy. End-stage renal failure prolonged the no-response period and duration of action of vecuronium and rocuronium after repeated incremental doses, but did not alter those attributed to atracurium.</p>

Neuromuscular and cardiovascular effects of rocuronium bromide / 中华麻醉学杂志

The neuromuscular and cardiovascular effects and endotracheal intubating conditions of bolus intravenous rocuronium 0.6mg/kg or 0.75mg/kg in 20 patients under balanced anesthesia,were studied, Intubating conditions were evaluated as excellent or good in all patients,except for one with poor intubating conditions following 0.6mg/kg. Onset times of both groups were 73.1 s and 67.1 s;neuromuscular blockade durations 24.9min and 32.0min; 25% recovery times 37.3min and 45.4min; 75% recovery times 46.4min and 58.7min;recovery index 9.1min and 13.3min,respectively. The cardiovascular effects after rocuronium in both groups were minimal.