Tempo de latencia e duracao do efeito do brometo de rocuronio no paciente submetido ao transplante renal
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Data
2000-01-01
Autores
Vianna, Pedro Thadeu Galvão [UNESP]
Takata, I. H. [UNESP]
Braz, José Reinaldo Cerqueira [UNESP]
Castiglia, Yara Marcondes Machado [UNESP]
Ganem, Eliana Marisa [UNESP]
De Carvalho, L. R. [UNESP]
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Resumo
Background and Objectives - Successful cadaver kidney transplantation relies on a fast procedure. Patients with chronic renal failure may present with a delayed gastric emptying making it critical a fast tracheal intubation and airway maintenance. Rocuronium a recently introduced nondepolarizing neuromuscular blocker with a fast onset. The aim of this study was to evaluate onset time and duration of rocuronium effects in patients undergoing renal transplantation. Methods - Sixty patients were allocated into two groups of 30: Group R (GR) = patients undergoing renal transplantation and Group N (GN) = patients with normal renal function. All patients were premedicated with oral midazolam (15 mg) and anesthesia was induced with 30 μg.kg-1 alfentanil, 0.3 mg.kg-1 etomidate and 0.6 mg.kg-1 rocuronium injected through a central venous catheter. neuromuscular block was monitored by acceleromyography in the ulnar nerve pathway. The following parameters were evaluated: time between administration of rocuronium and first twitch reduction to 5% after supra-maximal stimulation (T1) (onset time = OT); time for first twitch to return to 25% (clinical duration = R25); time elapsed between 25% and 75% recovery of first twitch (relaxation recovery time = R25-75). Heart rate (HR) and mean blood pressure (MBP) were recorded in 6 moments. Results - Median OT was 31 sec. in GR and 47 sec. in GN. Median R25 was 51.5 min in GR and 33.5 min in GN. Median R25-75 was 28 min in GR and 20 min in GN. MBP and HR were higher in GR. Tracheal intubation conditions were excellent for most patients in both groups. Conclusions - These results open the possibility of 0.6 mg.kg-1 rocuronium being injected through a central venous catheter when a faster onset is needed. Due to wide differences in individual responses, monitoring of neuromuscular block is recommended.
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Monitoring, neuromuscular: Acceleromyography, Neuromuscular Blockers, Nondepolarizing: Rocuronium, Surgery, Urologic: Renal transplantation, alfentanil, etomidate, midazolam, rocuronium, adult, anesthesia induction, anesthesia level, anesthetic recovery, central venous catheter, clinical article, controlled study, dose response, drug blood level, drug effect, endotracheal intubation, female, heart rate, human, kidney transplantation, male, mean arterial pressure, neuromuscular blocking
Como citar
Revista Brasileira de Anestesiologia, v. 50, n. 2, p. 98-194, 2000.