Intubating conditions after pipecuronium bromide: the influence of dose and time.
J Clin Anesth
; 3(3): 202-6, 1991.
Article
em En
| MEDLINE
| ID: mdl-1652264
ABSTRACT
STUDY OBJECTIVE:
To determine the intubating conditions following the administration of pipecuronium bromide in doses of two (0.07 mg/kg) or three (0.1 mg/kg) times ED95 (average dose that gives 95% block of the first twitch).DESIGN:
To compare intubating conditions at 11/2 and 21/2 minutes in 41 patients receiving balanced anesthesia.SETTING:
Surgical patients at Thomas Jefferson University Hospital. PATIENTS Forty-one patients undergoing surgical procedure who received general anesthesia.INTERVENTIONS:
After obtaining a stable baseline of train-of-four (TOF), 41 patients randomly received either 0.07 mg/kg or 0.1 mg/kg of pipecuronium as a single intravenous (IV) bolus dose, and the trachea was intubated either at 11/2 or 21/2 minutes. MEASUREMENTS AND MAINRESULTS:
Intubating conditions at 21/2 minutes appeared significantly better than those at 11/2 minutes, regardless of the pipecuronium dose. The mean time for T1 (first twitch of TOF) to reach 50% and 90% suppression was 1.36 +/- 0.51 minutes and 2.29 +/- 0.8 minutes, respectively, for the 0.07 mg/kg dose and 1.07 +/- 0.27 minutes and 1.72 +/- 0.45 minutes, respectively, for the 0.1 mg/kg dose. This did not make a significant difference in intubating conditions at either time. The time to 25% recovery of T1 was 68.2 +/- 22 minutes for the 0.07 mg/kg dose and 121.5 +/- 49 minutes for the 0.1 mg/kg dose. In patients who had spontaneous recovery of T1 to between 10% and 25% of control, administration of neostigmine or edrophonium resulted in identical recovery in 10 minutes. However, in patients with less than 10% spontaneous recovery of T1, neostigmine appeared to be superior to edrophonium.CONCLUSION:
Pipecuronium has a relatively rapid onset. The trachea could be intubated successfully in 11/2 minutes with a dose of either 0.07 mg/kg or 0.1 mg/kg. If the clinical situation requires perfect relaxation with no movement or bucking, we recommend waiting at least 21/2 minutes.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Piperazinas
/
Fármacos Neuromusculares não Despolarizantes
/
Androstano-3,17-diol
/
Intubação Intratraqueal
Tipo de estudo:
Clinical_trials
Limite:
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Clin Anesth
Assunto da revista:
ANESTESIOLOGIA
Ano de publicação:
1991
Tipo de documento:
Article
País de afiliação:
Panamá