ABSTRACT
BACKGROUND: We investigated the hypothesis that manipulation of cardiac output (CO) with esmolol (Es) or ephedrine (E) affects the onset time of rocuronium. METHODS: Following anesthesia induction, 33 patients received E (70 micro g kg-1), Es (500 micro g kg-1) or placebo (P) 30 s before rocuronium (0.6 mg kg-1) administration. Cardiac output was measured non-invasively after intubation every 3 min. The interval from the end of rocuronium administration to the disappearance of all twitches was considered to be the onset time. RESULTS: Onset time was shorter after E (52.2 +/- 16.5 s) and longer after Es (114.3 +/- 11.1 s) compared with P (87.4 +/- 7.3 s) (P < 0.0001). Cardiac output increased (P < 0.05) in group E for 15 min after rocuronium. In group Es, CO decreased (P < 0.05) at 3 and 6 min. Cardiac output was higher in group E vs. group Es, 3-6 min post administration of rocuronium (P=0.015). CONCLUSION: Pretreatment with E or Es appears to affect the onset time of rocuronium by altering CO as measured with the NICO (Non-Invasive Cardiac Output) monitor (Novametrix Medical Systems Inc., Willingford, CO).
Subject(s)
Androstanols/pharmacology , Cardiac Output/drug effects , Ephedrine/pharmacology , Neuromuscular Nondepolarizing Agents/pharmacology , Propanolamines/pharmacology , Adolescent , Adult , Anesthetics, Inhalation/pharmacology , Carbon Dioxide/analysis , Double-Blind Method , Female , Humans , Male , Middle Aged , Monitoring, Physiologic , Neuromuscular Junction/drug effects , Neuromuscular Junction/physiology , Prospective Studies , Rocuronium , Time FactorsSubject(s)
Analgesics, Opioid/adverse effects , Analgesics, Opioid/therapeutic use , Orthopedic Procedures , Pain, Postoperative/drug therapy , Sufentanil/adverse effects , Sufentanil/therapeutic use , Analgesics, Opioid/administration & dosage , Humans , Injections , Subarachnoid Space , Sufentanil/administration & dosageABSTRACT
IMPLICATIONS: The authors demonstrate that the combination of single and continuous peripheral nerve blocks allows the control of involuntary movements in patients undergoing awake craniotomy.