Search Results

rocuronium are combined, resulting in the formation of a precipitate due to discordant differences in pH. 3 Glycopyrrolate, an anticholinergic agent, and rocuronium, a nondepolarizing neuromuscular blocking agent, are 2 drugs commonly used during general anesthesia although usually not concurrently as glycopyrrolate is used during reversal of rocuronium-induced paralysis. However, coadministration may occur if the anticholinergic effects of glycopyrrolate are indicated independent of rocuronium administration. If the patient's physiologic state (eg, excessive

It is important to consider the potential for localized tissue damage and altered pharmacokinetics whenever a drug intended to be administered intravenously is inadvertently administered extravascularly. Although rocuronium is routinely used during general anesthesia and in intensive care units, the pharmacokinetics of infiltrated rocuronium have not been investigated, and there are few reports on infiltrated rocuronium in the existing literature. 1 – 4 We report a case of suspected rocuronium infiltration during the induction of general

estimated that there is 1 case for every 6,500 administrations. 2 Rocuronium is thought to have the highest frequency of allergic reactions. 3 We report 2 cases of anaphylaxis/anaphylactic shock believed to be induced by rocuronium, in which anaphylactic symptoms disappeared following administration of sugammadex and for which remission was achieved without further complications. In preparing this report, written consent for this publication was obtained from the patient herself (case 1) and from the patient and her parents (case 2

’s arrival at the operating room, standard anesthetic monitors were applied, intravenous (IV) access was obtained, and she was appropriately preoxygenated. General anesthesia was rapidly induced with IV propofol (130 mg) and fentanyl (100 μg) followed by rocuronium (40 mg; 0.66 mg/kg) after confirming ease of mask ventilation. Nasotracheal intubation was successfully performed without difficulty, and general anesthesia was maintained with O 2 (1 L/min), air (3 L/min), and sevoflurane (1.5%–2%) along with a remifentanil infusion (0.1–0.2 μg/kg/min). After induction and

demonstrate higher plasma concentrations than during conscious condition. 10 , 11 It is therefore suggested that these drugs may affect the muscle relaxant effects. In this study, we investigated the effect of regional administration of clinically relevant doses of lidocaine hydrochloride solution containing epinephrine on the muscle relaxant effects of rocuronium bromide. METHODS Subjects comprised 16 patients scheduled for orthognathic surgery, aged 17–36 years and classified in the American Society of Anesthesiologists (ASA) physical status I

The patient was a 7-year-old boy with asthma and allergies to egg and dairy. A slow inhalation induction was initiated in preparation for removal of an odontoma under general anesthesia. During the initial administration of anesthesia, we were able to maintain ventilation. However, ventilation difficulty, decreased blood pressure, and tachycardia occurred immediately after the administration of rocuronium. During direct laryngoscopy via standard laryngoscope, hypopharyngeal or glottic edema was not noted. We suspected an asthma attack, and

Many drugs can impact nondepolarizing muscle relaxants (NDMRs), leading to prolonged or enhanced neuromuscular blockade. Long-term use of antiepileptic drugs (AEDs) such as carbamazepine, phenytoin, and valproic acid has been reported to be associated with resistance to both the aminosteroidal (eg, rocuronium, vecuronium) and benzylisoquinolinium (eg, atracurium, cisatracurium) NDMRs. 1–10 Reports on the effects of newer AEDs (eg, lamotrigine, levetiracetam) on rocuronium are scarce and may not be well recognized. Herein, we report a case of delayed

is unclear. 1 , 2 Previously reported anesthetic concerns in patients taking lithium include the occurrence of lithium toxicity accompanying an inadequate perioperative fluid volume, potentiation of the effects of barbiturate anesthesia, and electrocardiogram changes. 2 Of particular clinical concern is the potentiation of muscle relaxants by lithium. Lithium reportedly potentiates both depolarizing 3 and nondepolarizing muscle relaxants. 4 , 5 The present report describes the case of potentiation and prolongation of rocuronium bromide after oral and

(Bridion) for the reversal of neuromuscular blockade induced by rocuronium or vecuronium. Sugammadex is a gamma cyclodextrin ring made up of 8 conjoined sugar molecules. It works by encapsulating a neuromuscular blocking drug (NMBD) in a 1:1 ratio. This encapsulation of the NMBD by sugammadex renders the NMBD unable to bind to acetylcholine nicotinic receptors. As plasma levels of the NMBD decrease, a rapid shift in the concentration gradient causes remaining NMBD to diffuse away from the neuromuscular junction. If enough sugammadex is used, a complete reversal of