1
|
Dória RGS, Ferraz GRL, Filippo PAD, Lacerenza MD, Fernandes LM, Oleskovicz N, Valadão CAA. Subarachnoid ketamine and ketamine s (+) associated with lidocaine in sheep and goats anesthesia. Vet Anim Sci 2021; 11:100148. [PMID: 33537507 PMCID: PMC7838716 DOI: 10.1016/j.vas.2020.100148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/12/2020] [Accepted: 09/30/2020] [Indexed: 11/24/2022] Open
Abstract
Ten male sheep (Sheep group; SGk) and seven male goats (Goat group; GGks+) were used in this study. The objective was to compare the use of racemic ketamine or ketamine S(+) associated with lidocaine on spinal anesthesia and evaluate if the drugs leads to a surgical anesthesia state, as well as to verify the cardiorespiratory, sedative and motor effects of this technique in these species. After correct placement of the needle in the subarachnoid space, 3.0 mg kg-1 of racemic ketamine (SGk) or ketamine S(+) (GGks+), both diluted in 1.5 mg kg-1 of 2% lidocaine, were administered. Evaluations were performed during orchiectomy, at times 0 (T0), 5 (T5), 10 (T10), 20 (T20), 30 (T30) and 60 (T60) minutes after subarachnoid anesthesia administration. No significant changes in heart and respiratory rates were observed in both experimental groups. All animals showed surgical analgesia and stood conscious or slightly sedated with ataxia immediately after the drugs administration (T5), allowing the execution of bilateral orchiectomy. The ataxia in SGk was classified as severe with recumbency in 80% of the animals, moderate ataxia in 10% of the animals, and mild ataxia in 10% of the animals. All goats (GGks+; 100%) presented severe ataxia and recumbency. At 60 min, animals of both groups were in standing position and with normal gait. Subarachnoid RS-ketamine and ketamine S(+) (3 mg kg-1), associated with lidocaine in sheep and goats, produces surgical anesthesia and recumbency without causing cardiorespiratory abnormalities, regurgitation and bloating.
Collapse
Affiliation(s)
- Renata Gebara Sampaio Dória
- Department of Veterinary Medicine, University of São Paulo (USP), Faculty of Animal Science and Food Engineering, Pirassununga,13.635-900, Brazil
| | | | | | - Milena Domingues Lacerenza
- Department of Veterinary Medicine, University of São Paulo (USP), Faculty of Animal Science and Food Engineering, Pirassununga,13.635-900, Brazil
| | - Letícia Martins Fernandes
- Department of Veterinary Sciences, Texas Tech University (TTU), College of Agricultural Sciences and Natural Resources, Lubbock, United States
| | - Nilson Oleskovicz
- Departament of Veterinary Medicine, Santa Catarina State University, Florianópolis, Santa Catarina, Brazil
| | - Carlos Augusto Araújo Valadão
- Department of Veterinary Internal Medicine and Surgery, São Paulo State University (UNESP), School of Agricultural and Veterinarian Sciences, Jaboticabal, Brazil
| |
Collapse
|
2
|
Trizotti JPSDS, Braga ADFDA, Carvalho VH, Braga FSDS. [Influence of different local anesthetics on atracurium neuromuscular blockade on rats]. Rev Bras Anestesiol 2020; 70:220-224. [PMID: 32522376 DOI: 10.1016/j.bjan.2020.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 12/23/2019] [Accepted: 01/03/2020] [Indexed: 10/24/2022] Open
Abstract
INTRODUCTION The association between Local Anesthetics (LAs) and Neuromuscular Blocking (NMB) drugs in clinical practice, and the possibility of interaction between these drugs has been investigated. LAs act on neuromuscular transmission in a dose-dependent manner and may potentiate the effects of NMB drugs. OBJECTIVE The aim of this study was to evaluate, in an experimental model, the effect of lidocaine and racemic bupivacaine on neuromuscular transmission and the influence on neuromuscular blockade produced by atracurium. METHODS Male Wistar rats, weighing from 250 g to 300g were used. The preparation was set up based on a technique proposed by Bülbring. Groups were formed (n = 5) according to the drug studied: lidocaine 20 μg.mL-1 (Group I); racemic bupivacaine 5 μg.mL-1 (Group II); atracurium 20 μg.mL-1 (Group III); atracurium 20 μg.mL-1 in a preparation previously exposed to lidocaine 20 μg.mL-1 and racemic bupivacaine 5 μg.mL-1, Groups IV and V, respectively. The following parameters were assessed: 1) Amplitude of hemi diaphragmatic response to indirect stimulation before and 60 minutes after addition of the drugs; 2) Membrane Potentials (MP) and Miniature Endplate Potentials (MEPPs). RESULTS Lidocaine and racemic bupivacaine alone did not alter the amplitude of muscle response. With previous use of lidocaine and racemic bupivacaine, the neuromuscular blockade (%) induced by atracurium was 86.66 ± 12.48 and 100, respectively, with a significant difference (p = 0.003), in comparison to the blockade produced by atracurium alone (55.7 ± 11.22). These drugs did not alter membrane potential. Lidocaine initially increased the frequency of MEPPs, followed by blockade. With the use of bupivacaine, the blockade was progressive. CONCLUSIONS Lidocaine and racemic bupivacaine had a presynaptic effect expressed by alterations in MEPPs, which may explain the interaction and potentiation of NMB produced by atracurium.
Collapse
Affiliation(s)
| | | | - Vanessa Henriques Carvalho
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Anestesiologia, Campinas, SP, Brasil.
| | - Franklin Sarmento da Silva Braga
- Universidade Estadual de Campinas (Unicamp), Faculdade de Ciências Médicas, Departamento de Anestesiologia, Campinas, SP, Brasil
| |
Collapse
|
3
|
Ida KK, Van-Wijnsberghe AS, Tutunaru A, Limpens V, Sauvage A, Serteyn D, Sandersen C. Onset and duration of cis-atracurium neuromuscular block during fentanyl and lidocaine infusions in isoflurane-anaesthetised dogs. Vet Rec 2020; 187:e33. [PMID: 31974268 DOI: 10.1136/vr.105522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 11/12/2019] [Accepted: 12/16/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND This retrospective study assessed the onset and duration of the neuromuscular block (NMB) induced by cis-atracurium 0.15 mg/kg intravenously with and without fentanyl or lidocaine infusions in 45 isoflurane-anaesthetised dogs. METHODS Dogs with neuromuscular function assessed by a calibrated train-of-four (TOF) monitor with stimulation (every 13 s) of the peroneal nerve were included. The onset and duration of the NMB were defined as the time from cis-atracurium administration until TOF=0 and the time during TOF=0 display, respectively. RESULTS The NMB onset was shorter during fentanyl (mean±sd) (1.9±0.7 minutes; P=0.0042) and lidocaine (2.0±0.7 minutes; P=0.0154) compared with control (2.9±0.8 minutes). The NMB duration was shorter in the fentanyl (27.5±7.3 minutes; P=0.0491), but not in the lidocaine group (32.3±6.9 minutes; P=0.0790), compared with control (33.7±9.1 minutes). The NMB onset was poorly but significantly correlated with the dose of fentanyl and lidocaine administered before cis-atracurium (r=-0.3396; P=0.0225). The fentanyl and lidocaine groups received more crystalloid and colloid boluses than the control. CONCLUSIONS Fentanyl and lidocaine shortened the NMB onset and the former decreased the NMB duration. Further prospective studies are required to clarify whether this was associated with an indirect decrease in blood pressure or a direct interaction between cis-atracurium and fentanyl and lidocaine.
Collapse
Affiliation(s)
- Keila K Ida
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| | | | - Alexandru Tutunaru
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| | - Véronique Limpens
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| | - Aurélie Sauvage
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| | - Didier Serteyn
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| | - Charlotte Sandersen
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Liège, Liège, Belgium
| |
Collapse
|
4
|
Carvalho V, Junqueira FF, Braga AA, Braga FS, Ribeiro CBL, Fernandez AC, Santos FC. Epidural administration of ropivacaine and its effects on the pharmacodynamics of rocuronium: Randomized controlled trial. Interaction between ropivacaine and rocuronium. Saudi J Anaesth 2020; 14:63-68. [PMID: 31998022 PMCID: PMC6970364 DOI: 10.4103/sja.sja_493_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 08/31/2019] [Accepted: 09/18/2019] [Indexed: 11/08/2022] Open
Abstract
Background: Potentiation of neuromuscular blocking agents by local anesthetics has been described in various clinical and experimental studies. This study assessed the influence of epidural ropivacaine on pharmacodynamic characteristics of rocuronium. Design: This was a prospective randomized clinical trial at the women's hospital, an university tertiary hospital in Brazil. Sixty-two patients underwent elective abdominal surgeries requiring general anesthesia. Intervention: Patients were distributed into two groups: Group 1 (general anesthesia and epidural anesthesia) and Group 2 (general anesthesia). In Group 1, 0.2% ropivacaine at a dose of 40 mg (20 ml) was associated with 2 mg (2 ml) of morphine in a single epidural injection. The following parameters were assessed: clinical duration (DC25) and time for recovery of the train-of-four (TOF) 0.9 ratio (T4/T1 = 90%) after an initial 0.6 mg/kg dose of rocuronium. The primary outcomes were DC25 and TOF 0.9 ratio (T4/T1 = 90%). Secondary outcomes were total propofol and remifentanil consumption. Results: Values were presented as median and interquartile range. The results for DC25 and TOF 0.9 of rocuronium were, respectively, 41.5 35.0–55.0 (25.0–63.0) in Group 1 and 44.0 37.0-51.0 (20.0–67.0) in Group 2 (P = 0.88); 88.0 67.0–99.0 (43.0–137.0) in Group 1; and 80.0 71.0-86.0 (38.0–155.0) in Group 2 (P = 0.83). There was no significant difference between the groups, in terms of pharmacodynamic characteristics of rocuronium. Propofol consumption did not show any difference between the groups. However, remifentanil consumption was significantly lower in Group 1 (P < 0.01). Conclusion: Epidural ropivacaine, in the dose studied, did not prolong the duration of rocuronium-induced neuromuscular blockade. Trial Registry Number: ReBEC (ref: RBR-7cyp6t).
Collapse
|
5
|
Santos FNC, Braga ADFDA, Junqueira FEF, Bezerra RM, de Almeida FF, Braga FSDS, Carvalho VH. Use of neuromuscular blockers and neostigmine for general anesthesia and its association with neuraxial blockade: A retrospective study. Medicine (Baltimore) 2017; 96:e7322. [PMID: 28658142 PMCID: PMC5500064 DOI: 10.1097/md.0000000000007322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This research aimed to assess the use of neuromuscular blockers (NMB) and its reversal, associated or not with neuraxial blockade, after general anesthesia.This retrospective study analyzed 1295 patients that underwent surgery with general anesthesia at Prof. Dr. José Aristodemo Pinotti Hospital in 2013. The study included patients aged >1 year, with complete, readable medical charts and anesthetic records.Rocuronium (ROC) was the most used NMB (96.7%), with an initial dose of 0.60 (0.52-0.74) mg/kg and total dose of 0.38 (0.27-0.53) mg/kg/h. In 24.3% of the cases, neuraxial blockade was associated with a significantly longer anesthesia (P < .001) than in cases without neuraxial block, regardless of technique (total intravenous (TIV) vs intravenous and inhalational (IV+IN)). In 71.9% of the cases, a single dose of NMB was used. Patients under TIV general anesthesia associated with neuraxial blockade had a lower total dose of ROC (mg/kg/h) in comparison with TIV GA alone (0.30 (0.23-0.39) and 0.42 (0.30-0.56) mg/kg/h, respectively, P < .001). The same was observed for patients under IV+IN GA (0.32 (0.23-0.41) and 0.43 (0.31-0.56) mg/kg/h, respectively, P < .001). The duration of anesthesia was longer according to increasing number of additional NMB doses (P < .001). Dose of neostigmine was 2.00 (2.00-2.00) mg or 29.41 (25.31-33.89) μg/kg. The interval between neostigmine and extubation was >30 minutes in 10.9% of cases.The most widely used NMB was ROC. Neuroaxial blockade (spinal or epidural) was significantly associated with reduced total dose of ROC (mg/kg/h) during general anesthesia, even in the absence of neuromuscular monitoring and regardless of general anesthetic technique chosen. In most cases, neostigmine was used to reverse neuromuscular block. The prolonged interval between neostigmine and extubation (>30 minutes) was neither associated with total doses of ROC or neostigmine, nor with the time of NMB administration. This study corroborates the important role of quantitative neuromuscular monitors and demonstrates that neuraxial blockade is associated with reduced total ROC dose. Further studies are needed to evaluate the possible role of neuraxial blockade in reducing the incidence of postoperative residual curarization.
Collapse
Affiliation(s)
- Filipe Nadir Caparica Santos
- Department of Anesthesiology
- Department of Pharmacology, State University of Campinas, Rua Tessália Vieira de Camargo, 126 – Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil - CEP 13083-887
| | - Angélica de Fátima de Assunção Braga
- Department of Anesthesiology
- Department of Pharmacology, State University of Campinas, Rua Tessália Vieira de Camargo, 126 – Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil - CEP 13083-887
| | - Fernando Eduardo Feres Junqueira
- Department of Pharmacology, State University of Campinas, Rua Tessália Vieira de Camargo, 126 – Cidade Universitária Zeferino Vaz, Campinas, SP, Brazil - CEP 13083-887
| | | | | | | | | |
Collapse
|
6
|
Carvalho VH, Braga ADFDA, Braga FSDS, Potério GMB, Santos FNC, Junqueira FEF. Association between levobupivacaine and pancuronium. Interference in neuromuscular transmission and blockade in rats. Acta Cir Bras 2017; 31:486-9. [PMID: 27487284 DOI: 10.1590/s0102-865020160070000009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Accepted: 06/24/2016] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To evaluate the effects of levobupivacaine on neuromuscular transmission and neuromuscular blockade produced by pancuronium in vitro. METHODS Thirty rats were distributed into groups (n = 5) according to the drug used alone or in combination: Group I - levobupivacaine (5 µg.mL-1); Group II - pancuronium (2 µg.mL-1); Group III - pancuronium (2 µg.mL-1) + levobupivacaine (5µg.mL-1). The following parameters were evaluated: 1) amplitude of diaphragmatic response to indirect stimulation, before and 60 minutes after the addition of levobupivacaine and pancuronium alone, and after the addition of levobupivacaine combined with pancuronium; 2) membrane potentials (MP) and miniature endplate potentials (MEPP). RESULTS Levobupivacaine alone did not alter the amplitude of muscle response and MP. In preparations previoulsy exposed to levobupivacaine, the block with pancuronium was significantly denser (90.2 ± 15.2%), showing a significant difference (p=0.031) in comparison to the block produced by pancuronium alone (48.9% ± 9.8%). There was a decrease in the frequency and amplitude of MEPPs. CONCLUSION Levobupivacaine potentiated the neuromuscular blockade produced by pancuronium, confirming a presynaptic action by a decrease in miniature endplate potentials.
Collapse
Affiliation(s)
- Vanessa Henriques Carvalho
- PhD, Department of Anesthesiology, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Brazil. Intellectual, scientific and design of the study; acquisition and interpretation of data; technical procedures; manuscript preparation and writing, critical revision, supervised all phases of the study
| | - Angélica de Fátima de Assunção Braga
- Associate Professor, Department of Anesthesiology, Faculty of Medical Sciences, UNICAMP, Campinas-SP, Brazil. Intellectual, scientific and design of the study; interpretation of data; technical procedures; manuscript preparation and writing, critical revision, supervised all phases of the study
| | | | - Gloria Maria Braga Potério
- Associate Professor, Department of Anesthesiology, Faculty of Medical Sciences, UNICAMP, Campinas-SP, Brazil. Critical revision
| | | | | |
Collapse
|
7
|
[Effect of ropivacaine combined with pancuronium on neuromuscular transmission and effectiveness of neostigmine and 4-aminopyridine for blockade reversal: experimental study]. Rev Bras Anestesiol 2014; 65:136-40. [PMID: 25666937 DOI: 10.1016/j.bjan.2013.10.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 10/31/2013] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The local anesthetic effects on neuromuscular junction and its influence on blockade produced by nondepolarizing neuromuscular blockers are still under-investigated; however, this interaction has been described in experimental studies and in humans. The aim of this study was to evaluate in vitro the interaction between ropivacaine and pancuronium, the influence on transmission and neuromuscular blockade, and the effectiveness of neostigmine and 4-aminopyridine to reverse the blockade. METHODS Rats were divided into groups (n=5) according to the study drug: ropivacaine (5μgmL(-1)); pancuronium (2μg.mL(-1)); ropivacaine+pancuronium. Neostigmine and 4-aminopyridine were used at concentrations of 2μgmL(-1) and 20μgmL(-1), respectively. The effects of ropivacaine on membrane potential and miniature end-plate potential, the amplitude of diaphragm responses before and 60minutes after the addition of ropivacaine (degree of neuromuscular blockade with pancuronium and with the association of pancuronium-ropivacaine), and the effectiveness of neostigmine and 4-aminopyridine on neuromuscular block reversal were evaluated. RESULTS Ropivacaine did not alter the amplitude of muscle response (the membrane potential), but decreased the frequency and amplitude of the miniature end-plate potential. Pancuronium blockade was potentiated by ropivacaine, and partially and fully reversed by neostigmine and 4-aminopyridine, respectively. CONCLUSIONS Ropivacaine increased the neuromuscular block produced by pancuronium. The complete antagonism with 4-aminopyridine suggests presynaptic action of ropivacaine.
Collapse
|
8
|
Braga ADFDA, Carvalho VH, Braga FSDS, Potério GMB, Santos FNC. Evidence of presynaptic and postsynaptic action of local anesthetics in rats. Acta Cir Bras 2013; 28:774-7. [DOI: 10.1590/s0102-86502013001100005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Accepted: 10/22/2013] [Indexed: 11/22/2022] Open
|
9
|
Sen S, Sari S, Kurt I, Cobanoglu M. The use of train of four monitoring for clinical evaluation of the axillary brachial plexus block. J Clin Monit Comput 2013; 28:243-9. [PMID: 24126617 DOI: 10.1007/s10877-013-9520-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2013] [Accepted: 10/09/2013] [Indexed: 12/17/2022]
Abstract
The axillary approach of brachial plexus anesthesia is the most commonly used technique for forearm and hand surgery. Dynamometer is known as objective test for the clinical assessment of motor block of the nerves in brachial plexus block. However, the use of this device may not always be practical in operating room. The train-of-four (TOF) test is a non-invasive peripheral nerve stimulator that shows the level of motor block of muscle relaxants. The aim of the study is to investigate the use of TOF testing as a peripheral nerve stimulator for objective clinical evaluation of motor block at axillary brachial plexus block. 44 patients were randomized according to the development of partial or complete motor in the axillary brachial plexus block. The nerves were selectively localized by nerve stimulation and ultrasound guidance. After obtaining an appropriate peripheral motor response, predetermined volumes of bupivacaine were selectively injected to the 4 nerves. Sensory, motor block levels and TOF values were measured at 10th, 20th, 30th minutes immediately after the axillary brachial plexus block. TOF values were gradually decreased and significant difference was observed between the development of a complete and partial motor block at 30th minute. TOF values were also significantly less in patients of complete sensory block than the patients of partial sensory block at 30th minute. The use of TOF monitoring may be beneficial to assess the objective clinical effect of motor block in the patients with axillary brachial plexus nerve block.
Collapse
Affiliation(s)
- Selda Sen
- Anaesthesiology and Reanimation Department, Adnan Menderes University Medical Faculty, 09100, Aydin, Turkey,
| | | | | | | |
Collapse
|
10
|
So SY, Kim YH, Ko YK, Park SI, Pak HJ, Jung WS. Effect of lidocaine (40 mg) mixed to prevent injection pain of propofol on the intubating conditions and onset time of rocuronium. Korean J Anesthesiol 2013; 64:29-33. [PMID: 23372883 PMCID: PMC3558645 DOI: 10.4097/kjae.2013.64.1.29] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Revised: 06/29/2012] [Accepted: 07/11/2012] [Indexed: 11/15/2022] Open
Abstract
Background To analyze how lidocaine 40 mg mixed prevents injection pain of propofol affects the onset time of rocuronium, tracheal intubating conditions and intubation related hemodynamic changes. Methods This study consisted of 70 patients with an American Society of Anesthesiologists (ASA) physical status class 1 or 2 for general anesthesia. All the patients were randomly allocated into two groups: propofol 2 mg/kg plus normal saline 2 ml (Group C) and propofol 2 mg/kg plus 2% lidocaine 40 mg (Group L). Each group was administrated intravenously during induction and the patient was intubated 1 minute after an injection of 0.6 mg/kg of rocuronium. The time at disappearance of the first twitch and intubation scores were recorded. Also, blood pressure and heart rate were measured at the baseline, after intravenous injection of propofol, before intubation, and at 0, 1, 2, 3 and 5 minutes after intubation. Results There were no significant differences between group C and L (P > 0.05). Conclusions 40 mg of lidocaine mixed with propofol to prevent injection pain did not affect the onset time of rocuronium, intubating conditions and intubation related hemodynamic changes.
Collapse
Affiliation(s)
- Sang Young So
- Department of Anesthesiology and Pain Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | | | | | | | | | | |
Collapse
|
11
|
Vivancos GG, Klamt JG, Garcia LV. Effects of 2 mg.kg⁻¹ of intravenous lidocaine on the latency of two different doses of rocuronium and on the hemodynamic response to orotracheal intubation. Rev Bras Anestesiol 2011; 61:1-12. [PMID: 21334502 DOI: 10.1016/s0034-7094(11)70001-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Accepted: 07/27/2010] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Lidocaine potentiates the effects of neuromuscular blockers and attenuates the hemodynamic response to orotracheal intubation. The objective of the present study was to test the effects of lidocaine on the latency of two different doses of rocuronium and on the hemodynamic response to intubation. METHODS Eighty patients were distributed in 4 groups: Groups 1 and 2 received 0.6 mg.kg(-1) of rocuronium; patients in Group 2 also received 2 mg.kg(-1) of lidocaine before intubation. Patients in Groups 3 and 4 received 1.2 mg.kg(-1) of rocuronium; patients in Group 4 received additional 2 mg.kg(-1) of lidocaine. The latency of the neuromuscular blockade was measured by acceleromyography. Hemodynamic evaluation was performed at baseline, immediately before, and 1 minute after orotracheal intubation (OI). RESULTS Statistically significant differences were not observed between the latency from 0.6 mg.kg(-1) and 1.2 mg.kg(-1) of rocuronium in patients who received lidocaine before induction and those who did not. The latency in patients who received 0.6 mg.kg(-1) of rocuronium with lidocaine was statistically similar to that of those who received 1.2 mg.kg(-1) rocuronium independently of whether lidocaine was administered or not. Patients who did not receive lidocaine before induction showed the same increases in systolic, diastolic, and mean arterial pressure and heart rate after OI, which was not observed in those patients who received lidocaine. CONCLUSIONS Intravenous lidocaine before anesthetic induction was capable of attenuating the hemodynamic response associated to OI maneuvers, but it did not reduce the latency of the neuromuscular blockade produced by two different doses of rocuronium.
Collapse
Affiliation(s)
- Gustavo Gameiro Vivancos
- Hospital das Clínicas de Ribeirão Preto da Faculdade de Medicina de Ribeirão Preto - FMRP, Brazil
| | | | | |
Collapse
|