[Optimum intubating dose of rocuronium for short duration surgery in adult patients].

BACKGROUND: The aim of this study was to examine optimum intubating dose of rocuronium in adult patients who had been scheduled for short duration surgery. METHODS: Thirty patients were randomly assigned to receive rocuronium 0.4 mg x kg(-1), 0.5 mg x kg(-1) or 0.6 mg x kg(-1) during induction with propofol and fentanyl. Immediately after the adduction of thumb to the ulnar nerve stimulation could not be visually observed, the patients were intubated tracheally and the intubating conditions were evaluated. Thereafter, time to recover to train-of-four (TOF) counts of 4 was recorded during sevoflurane and nitrous oxide anesthesia. RESULTS: Intubating conditions after rocuronium 0.5 and 0.6 mg x kg(-1) were all graded either excellent or good. In contrast, inadequate conditions for safe and easy tracheal intubation were observed in 60% of the patients receiving 0.4 mg x kg(-1). Time to spontaneous recover to the TOF counts of 4 correlated with the intubating doses of rocuronium. CONCLUSIONS: For short duration surgeries, rocuronium 0.5 mg x kg(-1) was appropriate to perform safe tracheal intubation and minimize duration of action of rocuronium.

Effect of landiolol hydrochloride on suxamethonium-induced neuromuscular block.

PURPOSE: The aim of this study was to examine the effect of landiolol hydrochloride, an ultrashort-acting beta(1)-blocker, on suxamethonium-induced neuromuscular block. METHODS: Thirty patients were randomly allocated to receive a loading dose of landiolol, 0.125 mg x kg(-1) x min(-1) for 1 min, followed by an infusion at 0.04 mg x kg(-1) x min(-1), or placebo. Twenty minutes after the infusion of landiolol or placebo, suxamethonium 1 mg x kg(-1) was administered during propofolfentanyl-nitrous oxide anesthesia. Neuromuscular block was monitored by train-of-four (TOF) responses of the adductor pollicis muscle, applying acceleromyographic stimuli to the ulnar nerve. RESULTS: The onset of neuromuscular block did not differ between the groups. The time from administration of suxamethonium to spontaneous recovery to the first twitch of TOF (T1) of control was significantly longer in the landiolol group (mean [SD]; 12.2 [2.5] min), when compared with the control group (9.8 [2.6] min). However, the TOF ratios measured when the T1 had spontaneously recovered to 10%, 25%, 50%, 75%, 90%, and 100% of control was comparable between the groups. CONCLUSION: Landiolol delayed recovery from suxamethonium-induced paralysis. However, the interaction between the drugs seemed to be small in the clinical setting.