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Kidney rocuronium

Qi Joy Yang, Michael Kluger, Krzysztof Goryński, Janusz Pawliszyn, Barbara Bojko, Ai-Ming Yu, Keumhan Noh, Markus Selzner, Angela Jerath, Stuart McCluskey, K Sandy Pang, Marcin Wąsowicz
The liver and kidney functions of recipients of liver transplantation (LT) surgery with heart beating (HBD, n = 13) or living donors (LD, n = 9) with different cold ischemia times were examined during the neohepatic phase for the elimination of rocuronium bromide (ROC, cleared by liver and kidney) and tranexamic acid (TXA, cleared by kidney). Solid phase micro-extraction and LC-MS/MS was applied to determine the plasma concentrations of ROC and TXA, and creatinine was determined by standard laboratory methods...
July 2017: Biopharmaceutics & Drug Disposition
Yasemin Isik, Onur Palabiyik, Bilal Muhammed Cegin, Ugur Goktas, Ismail Kati
BACKGROUND: Neostigmine, the currently commonly used agent for reversal of neuromuscular blockade. Sugammadex is a novel and unique compound designed as an antagonist of steroidal neuromuscular blockers. In this study, we evaluated the effects of sugammadex or neostigmine on kidney functions in patients scheduled for elective surgery. MATERIAL/METHODS: Patients scheduled for a surgical procedure under desflurane/opioid anesthesia received an intubating dose rocuronium...
March 10, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Camila M de Souza, Maria A Tardelli, Helio Tedesco, Natalia N Garcia, Mario P Caparros, Jose A Alvarez-Gomez, Itamar S de Oliveira Junior
BACKGROUND: Renal failure affects the pharmacology of nondepolarizing neuromuscular blockers making recovery of neuromuscular function unpredictable. Sugammadex antagonises rocuronium-induced neuromuscular blockade by encapsulating rocuronium, creating a stable complex molecule that is mainly excreted by the kidneys. Previous studies suggest that sugammadex is effective in reversing moderate neuromuscular block in the presence of renal failure, but no data are available regarding reversal of profound neuromuscular block in patients with renal failure...
October 2015: European Journal of Anaesthesiology
N Rahe-Meyer, C Berger, M Wittmann, C Solomon, E A M Abels, H Rietbergen, D A Reuter
BACKGROUND: Deep neuromuscular blockade (NMB) may not always be maintained to the end of surgery and the depth of block may be allowed to gradually diminish over time, particularly if reversal of NMB is not routinely performed. AIM: The current study aimed to assess recovery from deep rocuronium-induced NMB with sugammadex compared with placebo, provide data regarding the extent of residual blockade after deep rocuronium-induced NMB (placebo group), and to determine whether complete and reliable recovery could be provided by sugammadex (sugammadex group)...
July 2015: Der Anaesthesist
Kenichiro Koda, Masashi Uzawa, Haruka Kimura, Masaki Harada, Norie Sambe, Takayuki Sugano, Yasuo Ide, Takayuki Kitamura, Megumi Tagami
Churg-Strauss syndrome (CSS) is an uncommon disease characterized by bronchial asthma, eosinophilia and systemic vasculitis. Many patients with CSS are suffering from cardiovascular disorders, neurological disorders and/or renal disorders which are associated with systemic vasculitis. Cardiac diseases are considered as the main cause of the death in patients with CSS. Steroid administration is the standard pharmacological therapy for CSS. There are very few clinical reports concerning anesthetic management for the patients with CSS...
September 2014: Masui. the Japanese Journal of Anesthesiology
Tatsuhiko Shimizu, Yuichiro Toda, Kazuyoshi Shimizu, Tatsuo Iwasaki, Tomoyuki Kanazawa, Noriko Ishii, Kentaro Sugimoto, Hirokazu Kawase, Kiyoshi Morita
It is known that blood concentration of rocuronium increases after administration of sugammadex, but this is not clear in the case of vecuronium. We report a pediatric case in which serum vecuronium concentration increased following sugammadex administration after prolonged sedation using vecuronium. A 19-month-old girl weighing 7.8 kg had a history of aortic valvuloplasty at 4 months of age due to truncus arteriosus. She presented again to our hospital due to aortic regurgitation. She underwent aortic valvuloplasty and then aortic valve replacement...
October 2013: Masui. the Japanese Journal of Anesthesiology
Martijn Boon, Christian H Martini, Leon P H J Aarts, Rob F M Bevers, Albert Dahan
BACKGROUND: Surgical conditions in laparoscopic surgery are largely determined by the depth of neuromuscular relaxation. Especially in procedures that are confined to a narrow working field, such as retroperitoneal laparoscopic surgery, deep neuromuscular relaxation may be beneficial. Until recently, though, deep neuromuscular block (NMB) came at the expense of a variety of issues that conflicted with its use. However, with the introduction of sugammadex, rapid reversal of a deep NMB is feasible...
March 1, 2013: Trials
P Guerci, F Vial, J Raft, C Meistelman, H Bouaziz
Postoperative curarization following a single dose of rocuronium is a known risk quickly diagnosed through the monitoring of neuromuscular blockade. Different etiologies can cause a prolonged block. We report the case of a misdiagnosis of prolonged neuromuscular blockade by a failure in the monitoring system of curarization.
July 2012: Annales Françaises D'anesthèsie et de Rèanimation
G Cammu, B Van Vlem, M van den Heuvel, L Stet, R el Galta, S Eloot, I Demeyer
BACKGROUND: Renal excretion is the primary route for the elimination of sugammadex. We evaluated the dialysability of sugammadex and the sugammadex-rocuronium complex in patients with severe renal impairment in the intensive care unit (ICU). METHODS: Six patients in the ICU with acute severe renal impairment received general anaesthesia for transoesophageal echocardiography, to replace their tracheal tubes, or for bronchoscopy. Five of the six patients were in the ICU after cardiac/vascular surgery and one for pneumonia-induced respiratory failure...
September 2012: British Journal of Anaesthesia
Min Soo Kim, Jung Woo Park, Yun Hee Lim, Byung Hoon Yoo, Jun Heum Yon, Dong Won Kim
BACKGROUND: Ulinastatin is a glycoprotein derived from human urine and a serine protease inhibitor found in human urine and blood. Ulinastatin increases both liver blood flow and urine output. Rocuronium is eliminated mainly through the liver and partly through the kidney, hepatic elimination of rocuronium might be enhanced by ulinastatin. We examined the effect of ulinastatin on the neuromuscular block caused by rocuronium. METHODS: Forty four adult patients were randomly divided into two groups of 22 patients each, i...
March 2012: Korean Journal of Anesthesiology
Nevena Kalezić, Biljana Krivić, Vladan Živaljević, Djordje Ugrinović, Dijana Jovanović, Dejan Marković, Jelena Veličković, Nebojša Ladjević
INTRODUCTION: Anaesthesia affects kidney function by reducing the renal blood flow and glomerular filtration rate. As chronic renal failure (CRF) significantly influences drug metabolism and elimination, we studied the effects of rocuronium bromide (RB) in patients with CRF. OBJECTIVE: The aim of the study was to examine whether, when using RB in patients with CFR, there are differences regarding the onset time of neuromuscular block (NMB) development, duration time, speed of recovery and cumulative effects of RB...
November 2011: Srpski Arhiv za Celokupno Lekarstvo
I Cordero Escobar, B Rey Martínez, R Company Teuler, A Pérez Carbonell
We report the use of sugammadex to reverse a rocuronium block in a man who had received a kidney transplant 4 years earlier. The patient was admitted for gastric non-Hodgkins lymphoma and bleeding that required surgery. Arterial hypertension, tachycardia, and frequent ventricular extrasystoles were detected. Anesthetic induction was accomplished with propofol, fentanyl, and rocuronium; intubation was uneventful. We monitored pulse oximetry, capnography, heart rate, electrocardiography, arterial pressure (invasive), cardiac output, end-systolic volume, bispectral index, temperature, and neuromuscular function...
December 2011: Revista Española de Anestesiología y Reanimación
Grégory A Hans, Besongo Bosenge, Vincent L Bonhomme, Jean F Brichant, Ingrid M Venneman, Pol C Hans
CONTEXT: Intravenous magnesium deepens non-depolarising neuromuscular block. OBJECTIVE: To assess whether intravenous magnesium has the potential to re-establish paralysis in patients who have just recovered from a non-depolarising neuromuscular block. DESIGN: Prospective randomised double-blind controlled study. PATIENTS: Twenty non-obese patients ranging in age from 18 to 80 years were enrolled. Exclusion criteria were a history of liver, kidney or neuromuscular disease and intake of medications interacting with neuromuscular blocking agents...
February 2012: European Journal of Anaesthesiology
P E Dubois, M Gourdin, J Jamart, S M Broka, P Eucher, A D'Hollander
BACKGROUND: Neuromuscular blocking agents have always shown wide inter-individual variability when it comes to their duration of action. This prevents clinicians from anticipating the evolution of the neuromuscular block for any given patient. With this study, we aimed to assess the nature of the relationships existing between different time course parameters used to describe paralysis onset and offset. METHODS: Sixty American Society of Anesthesiologists (ASA) score III-IV anaesthetised patients were randomised to receive a single equipotent dose (2ED95) of either rocuronium, mivacurium or atracurium...
January 2012: Acta Anaesthesiologica Scandinavica
Habib Bostan, Yıldıray Kalkan, Yakup Tomak, Levent Tumkaya, Durdu Altuner, Adnan Yılmaz, Baar Erdivanli, Recep Bedir
BACKGROUND: This study investigated the effect of injection of rocuronium or sugammadex alone and rocuronium + sugammadex on urea, creatinine, electrolyte levels, and histopathological findings in rats. METHODS: Thirty-six Sprague-Dawley male rats were divided to receive intravenously 16 or 96 mg/kg sugammadex, 1 mg/kg rocuronium, 1 mg/kg rocuronium + 16 mg/kg sugammadex, or 1 mg/kg rocuronium + 96 mg/kg sugammadex. The control group received an equal volume of physiological serum...
2011: Renal Failure
O Menouni, A-C Brillouet-Banchereau, G Galan, A Lélias, A Sautereau, S Gadrey
Postoperative curarization in patients has been established. Nevertheless, extremely prolonged neuromuscular blockades are rare. We report the case of a prolonged neuromuscular blockade (lasting 10 hours) following a single dose of rocuronium, in an elderly patient with severe renal failure. We have studied the possible causes of prolonged curarization, and discussed the interest of the use of sugammadex in such cases.
November 2011: Annales Françaises D'anesthèsie et de Rèanimation
M Briere, C Boisson, P Cuvillon, B Debaene, J Ripart
We report a case of delayed rocuronium-induced deep block antagonization with sugammadex, thus requiring a total of three injections and a cumulative dose of 12 mg/kg over a 30 min period. The patient was an emergency case with full stomach that had required a rapid sequence induction. Because of hyperkaliemia due to an acute renal failure, rocuronium was preferred to succinylcholine. Use of sugammadex in the acute renal failure context is discussed.
October 2011: Annales Françaises D'anesthèsie et de Rèanimation
Huub J Kleijn, Daniel P Zollinger, Michiel W van den Heuvel, Thomas Kerbusch
AIMS: An integrated population pharmacokinetic-pharmacodynamic model was developed with the following aims: to simultaneously describe pharmacokinetic behaviour of sugammadex and rocuronium; to establish the pharmacokinetic-pharmacodynamic model for rocuronium-induced neuromuscular blockade and reversal by sugammadex; to evaluate covariate effects; and to explore, by simulation, typical covariate effects on reversal time. METHODS: Data (n= 446) from eight sugammadex clinical studies covering men, women, non-Asians, Asians, paediatrics, adults and the elderly, with various degrees of renal impairment, were used...
September 2011: British Journal of Clinical Pharmacology
M D Shul'zhenko, B D Babaev, M V Shishkov, G B Svarinskaia, N N Garbuzova, I F Ostreĭkov
The purpose of the study is to optimize the general anesthesia for laparoscopic surgery in children with rokuronium bromide. We investigated the effect of rokuronium on children from 3 to 17 years of age who underwent laparoscopic surgery for up to one hour in the department of anesthesiology and resuscitation of Tushino City Pediatric Hospital. The study included 31 children rated ASA I-II. The children with concomitant liver and kidney dysfunction, cardiovascular, pulmonary, neuromuscular and psychoneurological disorders were excluded from the study group...
January 2011: Anesteziologiia i Reanimatologiia
Yutaka Yamazaki, Atsushi Saito, Hiromu Takahashi
A 59-year-old man with chronic renal failure underwent the ascending colectomy. After administration of neostigmine 2 mg, his postoperative neuromuscular recovery was good. The second laparotomy was undertaken one hour after extubation because gauze was left in his abdomen. Fifty minutes after intubation using rocuronium 40 mg (0.6 mg x kg(-1)), neostigmine 4 mg (0.06 mg x kg(-1)) was administrated. But we failed to reverse neuromuscular blockade and the patient fell into respiratory depression. After a chain of two operations, the administration of neostigmine in second operation requires circumspection when the effect of neostigmine administrated in the first operation is continuing, because the proper evaluation of residual neuromuscular blockade is difficult...
February 2011: Masui. the Japanese Journal of Anesthesiology
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