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Titolo:
Rapacuronium bromide - A review of its use in anaesthetic practice
Autore:
Onrust, SV; Foster, RH;
Indirizzi:
Adis Int Ltd, Auckland 10, New Zealand Adis Int Ltd Auckland New Zealand10 s Int Ltd, Auckland 10, New Zealand
Titolo Testata:
DRUGS
fascicolo: 5, volume: 58, anno: 1999,
pagine: 887 - 918
SICI:
0012-6667(199911)58:5<887:RB-ARO>2.0.ZU;2-J
Fonte:
ISI
Lingua:
ENG
Soggetto:
NEUROMUSCULAR BLOCKING-AGENTS; MUSCLE-RELAXANTS; PHARMACOLOGICAL BLOCKADE; INTUBATING CONDITIONS; ADDUCTOR POLLICIS; D-TUBOCURARINE; TIME-COURSE; ORG-9487; PHARMACOKINETICS; PHARMACODYNAMICS;
Keywords:
rapacuronium bromide; intubation; neuromuscular blocking agent; pharmacodynamics; pharmacokinetics; therapeutic use.; adverse events;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
77
Recensione:
Indirizzi per estratti:
Indirizzo: Onrust, SV Adis Int Ltd, 41 Centorian Dr,Private Bag 65901, Auckland 10, New Zealand Adis Int Ltd 41 Centorian Dr,Private Bag 65901 Auckland New Zealand 10
Citazione:
S.V. Onrust e R.H. Foster, "Rapacuronium bromide - A review of its use in anaesthetic practice", DRUGS, 58(5), 1999, pp. 887-918

Abstract

Rapacuronium bromide (rapacuronium) is an aminosteroid, nondepolarising neuromuscular blocking agent (NMBA). At the recommended dose for endotrachealintubation (1.5 mg/kg), an intravenous bolus of rapacuronium has a rapid onset (approximate to 1.2 to 1.8 minutes) and short duration of action (10.2to 16.5 minutes) in adults undergoing elective surgery, Rapacuronium 1.5 mg/kg produced clinically acceptable incubating conditions in 68 to 89% of these patients at about 1 minute after administration. The onset, extent andduration of action and clinical efficacy of an incubating dose of rapacuronium appeared to be similar in the general adult population, adult patientswith renal or hepatic dysfunction, patients undergoing Caesarean section, and elderly, paediatric or obese adult patients. Onset time with rapacuronium 1.3 to 2.5 mg/kg (0.9 to 1.8 minutes) was similar tr,or slower than that with a 1 mg/kg dose of the depolarising NMBA suxamethonium chloride (0.8 to 1.2 minutes), Intubating conditions were clinically acceptable about 1 minute after administration in 86 to 100% of patients with rapacuronium 1.3 to 2.5 mg/kg compared with in 88 to 97% of patients with suxamethonium chloride 1 or 1.5 mg/kg, Spontaneous recovery was slower with rapafuronium than with suxamethonium chloride, but neostigmine 0.04 or 0.05 mg/kg administered 2 or 5 minutes after rapacuronium 1.3 or 1,5 mg/kg accelerated recovery,In the few available comparative clinical trials, rapacuronium 1.5 mg/kg appeared to have a more rapid onset of action than the nondepolarising NMBAsmivacurium chloride 0.25 mg/kg, rocuronium bromide 0.45 or 0.6 mg/kg or vecuronium bromide 0.07 mg/kg, and a shorter duration of action than rocuronium bromide 0.45 or 0.6 mg/kg or vecuronium bromide 0.07 mg/kg,Additional boluses (less than or equal to 3) of of rapacuronium 0.5 or 0.55 mg/kg after an intubating bolus of 1,5 mg/kg provided continued skeletal muscle relaxation during short surgical procedures in adult patients. However, these patients may recover more slowly than those who receive a single bolus of the drug,Bronchospasm was the most common treatment-related adverse event with rapacuronium 0.3 to 3 mg/kg (3.4% of adult patients). Tachycardia, injection site reaction and hypotension were also reported in small proportions of patients (1.6, 1.1 and 0.9%). The overall incidence of drug-related adverse events was similar with rapacuronium 1.5 or 2.5 mg/kg or suxamethonium chloride 1 mg/kg (8 vs 6%) but bronchospasm, tachycardia and injection site reaction tended to occur more often with rapacuronium. Conclusions: At the recommended dose of 1.5 mg/kg, the nondepolarising NMBA rapacuronium has a rapid onset and short duration of action. It may provide a nondepolarising alternative to suxamethonium chloride for endotrachealintubation. Rapacuronium may be preferred over rocuronium bromide, vecuronium bromide or mivacurium chloride in this indication.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/04/20 alle ore 00:28:13