>Cirugía y Cirujanos
>Year 2000, Issue 6
Peñuelas-Acuña J, Oriol-López SA, Pérez-Terrazas H
Rocuronium bromide in patients with terminal renal failure
Cir Cir 2000; 68 (6)
PDF: 90.18 Kb.
[Full text - PDF]
The available non-depolarizing neuromuscular blockers (NDNMB), such as rocuronium bromide, have shown pharmacological features that allow their use with a wider security margin in-patients with terminal renal failure (TRF). To prove the effectiveness of rocuronium a prospective, descriptive, longitudinal, and experimental study was carried out in 18 patients with TRF. Measures were taken for action, duration, and recovery time of NDNMB produced with 0.600 mg/kg (2DE90) doses, total intravenous anesthesia of propofol + fentanyl, and 100% oxygen ventilation in patients subjected to Tenchkoff catheter placement. Results show the following: 65 sec average time for traqueal intubation; 30 min, recovery of 25-75%, and 40 min recovery 25-80%, which doubles that of the healthy patient; five patients were reverted and received an extra dose, and no recurarization cases were presented. It can be concluded that rocuronium has a good security margin for patients with TRF heaving in mind that elimination half-life is increased 100% and NMB monitoring is required.
||, Rocuronium bromide, Terminal renal failure, Total intravenous anesthesia.
Brenner, Rector. Excreción de fármacos. 5ta. Ed. 1996. WB Saunders Company.
Castro Tavares J, Lencastre L. Relaxantes musculares na insuficiência renal e trasplante renal. In: Alvarez Gómez JA Editors. Relajantes musculares. ELA; 1996: 359.
Pineda Díaz MV, Alvarez Gómez JA. Rocuronio. In: Alvarez Gómez JA. Editors. Relajantes musculares de. ELA, 1996: 173.
Shiraishi H, Suzuki H, Suzuki T, Katsumata N, Ogawua S. Fading responses in the evoked EMG after rocuronium in cats. Can J Anaesth 1994; 11(9): 9–15.
Tian L, Mehta M P, Prior C, Marshall IG. Relative pre and postjunctional effects of a new vecuronium analogue, Org 9426, at the rat neuromuscular junction. Br J Anaesth 1992; 62: 284–287.
Golpariani M, Ohta Y, Nagashima H, Goldiner PL, Foldes FF. Org. 9426 potentates neuromuscular blocking effects of other non depolarizing muscle relaxants in rats. Anaesth Analg 1990; 70: S131.
Foldes FF, Nagashima H, Nguyen H, Ohta Y. The clinical pharmacology of Org 9426. In: Bowman WC et al. Editors. Neuromuscular blocking agents: past, present and future. Excerpta Médica Amsterdan,The Netherlands; 1990: 171–181.
Magorian T, Flannery KB, Miller RD. Comparison of rocuronium, succinilcoline and vecuronium for rapid-sequence induction of anesthesia in adult patients. Anesthesiology 1993; 79: 913-918.
Pollard BJ, Chetty MS, Wilson A, Healy TEJ. Intubation conditions and time course of action of low dose rocuronium bromide in day case dental surgery. Eur J Anesth 1995; 12(11): 81–83.
Prien T, Zahn P, Menges M, Brussel T. 1 X ED90 dose of rocuronium bromide: tracheal intubation conditions and time course of action. Eur J Anesth 1995; 12(11): 85–90.
Mirakhur RK. Safety aspects of neuromuscular block agents with special reference to rocuronium bromide. Eur J Anesth. 1994; 11(9): 133–140.
Khuenl-Brady KS, Pomaroli A, Pühringer F, Mitterschiffthaler G, Koller J. The use of rocuronium (Org 9426) in patients with chronic renal failure. Anaesthesia 1993; 48: 873–875.
Brugger AJ, Alvarez Gómez. In: Alvarez Gómez JA, editor Relajantes musculares. ELA; 1996: 231–242.
Ghoenhein MM, Kramer E, Bannow R, Pandya H, Routh JI. Binding of d-Tubocurarine to plasma proteins in normal humans and in patients with hepatic or renal disease. Anesthesiology 1973; 39: 410–415.
Foldes FF, Deery A. Protein binding of atracurium and other short-acting neuromuscular blocking agents and their interaction with human cholinesterase. Anesth 1983; 55: 315.
Mayer M, Doenicke A, Hoffmann, Peter K. Onset and recovery of rocuronium and vecuronium under enfluorane anaesthesia. Br J Anaesth 1992;69: 511–512.
Cooper RA, Mirakhur RK, Wierda JMKH, maddineni VR. Pharmacokinetics of rocuronium bromide in patients with and without renal failure. Eur J Anesth 1995; 12(S11): 43–44.
Wierda JMKH, Proost JH, Schiere S, Hommes FDM. Pharmacokinetics and pharmacokinetic/dynamic relationship of rocuronium bromide in humans. Eur J Anesth 1994; 11(9): 66–74.
>Cirugía y Cirujanos
>Year 2000, Issue 6