Comparison of the Intubation conditions provided by rapacuronium (ORG 9487) or succinylcholine in humans during anesthesia with fentanyl and propofol
Currently, the only approved muscle relaxant with a rapid onset and short duration of action is succinylcholine, a drug with some undesirable effects. Rapacuronium is an investigational nondepolarizing relaxant that also has a rapid onset and short duration and consequently should be compared with s...
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| Veröffentlicht in: | Anesthesiology (Philadelphia) 1999-11, Vol.91 (5), p.1311-1317 |
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| creator | FLEMING, N. W CHUNG, F GLASS, P. S. A KITTS, J. B KIRKEGAARD-NIELSEN, H GRONERT, G. A CHAN, V GAN, T. J CICUTTI, N CALDWELL, J. E |
| description | Currently, the only approved muscle relaxant with a rapid onset and short duration of action is succinylcholine, a drug with some undesirable effects. Rapacuronium is an investigational nondepolarizing relaxant that also has a rapid onset and short duration and consequently should be compared with succinylcholine in its ability to facilitate rapid tracheal intubation.
This prospective, randomized clinical trial involved 336 patients. Anesthesia was induced with fentanyl and propofol and either 1.5 mg/kg rapacuronium or 1.0 mg/kg succinylcholine. The goal was to accomplish tracheal intubation by 60 s after administration of the neuromuscular blocking drug. Endotracheal intubation was performed, and conditions were graded by a blinded investigator. Recovery of neuromuscular function was assessed by electromyography.
Intubation conditions were evaluated in 236 patients. Intubation by 60 s after drug administration occurred in 100% of patients with rapacuronium and in 98% with succinylcholine. Intubation conditions were excellent or good in 87% of patients with rapacuronium and in 95% with succinylcholine (P < 0.05). The time (median and range) to the first recovery of the train-of-four response was 8.0 (2.8-20.0) min with rapacuronium and 5.7 (1.8-17.7) min with succinylcholine (P < 0.05). The overall incidence of adverse effects was similar with both drugs.
A 1.5-mg/kg dose of rapacuronium effectively facilitates rapid tracheal intubation. It can be considered a valid alternative to 1.0 mg/kg succinylcholine for this purpose. |
| doi_str_mv | 10.1097/00000542-199911000-00023 |
| format | Article |
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This prospective, randomized clinical trial involved 336 patients. Anesthesia was induced with fentanyl and propofol and either 1.5 mg/kg rapacuronium or 1.0 mg/kg succinylcholine. The goal was to accomplish tracheal intubation by 60 s after administration of the neuromuscular blocking drug. Endotracheal intubation was performed, and conditions were graded by a blinded investigator. Recovery of neuromuscular function was assessed by electromyography.
Intubation conditions were evaluated in 236 patients. Intubation by 60 s after drug administration occurred in 100% of patients with rapacuronium and in 98% with succinylcholine. Intubation conditions were excellent or good in 87% of patients with rapacuronium and in 95% with succinylcholine (P < 0.05). The time (median and range) to the first recovery of the train-of-four response was 8.0 (2.8-20.0) min with rapacuronium and 5.7 (1.8-17.7) min with succinylcholine (P < 0.05). The overall incidence of adverse effects was similar with both drugs.
A 1.5-mg/kg dose of rapacuronium effectively facilitates rapid tracheal intubation. It can be considered a valid alternative to 1.0 mg/kg succinylcholine for this purpose.</description><identifier>ISSN: 0003-3022</identifier><identifier>EISSN: 1528-1175</identifier><identifier>DOI: 10.1097/00000542-199911000-00023</identifier><identifier>PMID: 10551582</identifier><identifier>CODEN: ANESAV</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Aging - physiology ; Anesthetics, Combined - adverse effects ; Anesthetics, Intravenous ; Anesthetics. Neuromuscular blocking agents ; Biological and medical sciences ; Blood Pressure - drug effects ; Female ; Fentanyl ; Heart Rate - drug effects ; Humans ; Intubation, Intratracheal ; Male ; Medical sciences ; Middle Aged ; Neuromuscular Blocking Agents - adverse effects ; Neuropharmacology ; Pharmacology. Drug treatments ; Propofol ; Prospective Studies ; Succinylcholine - adverse effects ; Vecuronium Bromide - adverse effects ; Vecuronium Bromide - analogs & derivatives</subject><ispartof>Anesthesiology (Philadelphia), 1999-11, Vol.91 (5), p.1311-1317</ispartof><rights>1999 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c390t-e9ad5abb0cc9aca77332880eb727de0176fc33b1b90c1ba8e94803a7ca8c21033</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1993423$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10551582$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>FLEMING, N. W</creatorcontrib><creatorcontrib>CHUNG, F</creatorcontrib><creatorcontrib>GLASS, P. S. A</creatorcontrib><creatorcontrib>KITTS, J. B</creatorcontrib><creatorcontrib>KIRKEGAARD-NIELSEN, H</creatorcontrib><creatorcontrib>GRONERT, G. A</creatorcontrib><creatorcontrib>CHAN, V</creatorcontrib><creatorcontrib>GAN, T. J</creatorcontrib><creatorcontrib>CICUTTI, N</creatorcontrib><creatorcontrib>CALDWELL, J. E</creatorcontrib><title>Comparison of the Intubation conditions provided by rapacuronium (ORG 9487) or succinylcholine in humans during anesthesia with fentanyl and propofol</title><title>Anesthesiology (Philadelphia)</title><addtitle>Anesthesiology</addtitle><description>Currently, the only approved muscle relaxant with a rapid onset and short duration of action is succinylcholine, a drug with some undesirable effects. Rapacuronium is an investigational nondepolarizing relaxant that also has a rapid onset and short duration and consequently should be compared with succinylcholine in its ability to facilitate rapid tracheal intubation.
This prospective, randomized clinical trial involved 336 patients. Anesthesia was induced with fentanyl and propofol and either 1.5 mg/kg rapacuronium or 1.0 mg/kg succinylcholine. The goal was to accomplish tracheal intubation by 60 s after administration of the neuromuscular blocking drug. Endotracheal intubation was performed, and conditions were graded by a blinded investigator. Recovery of neuromuscular function was assessed by electromyography.
Intubation conditions were evaluated in 236 patients. Intubation by 60 s after drug administration occurred in 100% of patients with rapacuronium and in 98% with succinylcholine. Intubation conditions were excellent or good in 87% of patients with rapacuronium and in 95% with succinylcholine (P < 0.05). The time (median and range) to the first recovery of the train-of-four response was 8.0 (2.8-20.0) min with rapacuronium and 5.7 (1.8-17.7) min with succinylcholine (P < 0.05). The overall incidence of adverse effects was similar with both drugs.
A 1.5-mg/kg dose of rapacuronium effectively facilitates rapid tracheal intubation. It can be considered a valid alternative to 1.0 mg/kg succinylcholine for this purpose.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aging - physiology</subject><subject>Anesthetics, Combined - adverse effects</subject><subject>Anesthetics, Intravenous</subject><subject>Anesthetics. Neuromuscular blocking agents</subject><subject>Biological and medical sciences</subject><subject>Blood Pressure - drug effects</subject><subject>Female</subject><subject>Fentanyl</subject><subject>Heart Rate - drug effects</subject><subject>Humans</subject><subject>Intubation, Intratracheal</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neuromuscular Blocking Agents - adverse effects</subject><subject>Neuropharmacology</subject><subject>Pharmacology. Drug treatments</subject><subject>Propofol</subject><subject>Prospective Studies</subject><subject>Succinylcholine - adverse effects</subject><subject>Vecuronium Bromide - adverse effects</subject><subject>Vecuronium Bromide - analogs & derivatives</subject><issn>0003-3022</issn><issn>1528-1175</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkMtOxCAUhonROOPlFQwLF7qocpkKLM1ERxMTE6Pr5kCpg2mhgVYzD-L7yjjjhYTAOfz_f8iHEKbkghIlLsl6lTNWUKUUpbko8mZ8B01pyWRBqSh30TT3eMEJYxN0kNJbLkXJ5T6aUFKWtJRsij7noeshuhQ8Dg0elhbf-2HUMLjcMcHXbn1LuI_h3dW2xnqFI_Rgxhi8Gzt89vi0wGomxTkOEafRGOdXrVmG1nmLncfLsYMcUI_R-VcM3qY8JTnAH25Y4sb6AbIhP9TrIX1oQnuE9hpokz3enofo5fbmeX5XPDwu7ufXD4XhigyFVVCXoDUxRoEBIThnUhKrBRO1JVRcNYZzTbUihmqQNn-TcBAGpGGUcH6I5CbXxJBStE3VR9dBXFWUVGvS1Q_p6pd09U06W0821n7Una3_GTdos-B0K4BkoG0ieOPSn04pPss5X7-NiPY</recordid><startdate>19991101</startdate><enddate>19991101</enddate><creator>FLEMING, N. W</creator><creator>CHUNG, F</creator><creator>GLASS, P. S. A</creator><creator>KITTS, J. B</creator><creator>KIRKEGAARD-NIELSEN, H</creator><creator>GRONERT, G. A</creator><creator>CHAN, V</creator><creator>GAN, T. J</creator><creator>CICUTTI, N</creator><creator>CALDWELL, J. E</creator><general>Lippincott</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>19991101</creationdate><title>Comparison of the Intubation conditions provided by rapacuronium (ORG 9487) or succinylcholine in humans during anesthesia with fentanyl and propofol</title><author>FLEMING, N. W ; CHUNG, F ; GLASS, P. S. A ; KITTS, J. B ; KIRKEGAARD-NIELSEN, H ; GRONERT, G. A ; CHAN, V ; GAN, T. J ; CICUTTI, N ; CALDWELL, J. 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Drug treatments</topic><topic>Propofol</topic><topic>Prospective Studies</topic><topic>Succinylcholine - adverse effects</topic><topic>Vecuronium Bromide - adverse effects</topic><topic>Vecuronium Bromide - analogs & derivatives</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>FLEMING, N. W</creatorcontrib><creatorcontrib>CHUNG, F</creatorcontrib><creatorcontrib>GLASS, P. S. A</creatorcontrib><creatorcontrib>KITTS, J. B</creatorcontrib><creatorcontrib>KIRKEGAARD-NIELSEN, H</creatorcontrib><creatorcontrib>GRONERT, G. A</creatorcontrib><creatorcontrib>CHAN, V</creatorcontrib><creatorcontrib>GAN, T. J</creatorcontrib><creatorcontrib>CICUTTI, N</creatorcontrib><creatorcontrib>CALDWELL, J. E</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Anesthesiology (Philadelphia)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>FLEMING, N. W</au><au>CHUNG, F</au><au>GLASS, P. S. A</au><au>KITTS, J. B</au><au>KIRKEGAARD-NIELSEN, H</au><au>GRONERT, G. A</au><au>CHAN, V</au><au>GAN, T. J</au><au>CICUTTI, N</au><au>CALDWELL, J. E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of the Intubation conditions provided by rapacuronium (ORG 9487) or succinylcholine in humans during anesthesia with fentanyl and propofol</atitle><jtitle>Anesthesiology (Philadelphia)</jtitle><addtitle>Anesthesiology</addtitle><date>1999-11-01</date><risdate>1999</risdate><volume>91</volume><issue>5</issue><spage>1311</spage><epage>1317</epage><pages>1311-1317</pages><issn>0003-3022</issn><eissn>1528-1175</eissn><coden>ANESAV</coden><abstract>Currently, the only approved muscle relaxant with a rapid onset and short duration of action is succinylcholine, a drug with some undesirable effects. Rapacuronium is an investigational nondepolarizing relaxant that also has a rapid onset and short duration and consequently should be compared with succinylcholine in its ability to facilitate rapid tracheal intubation.
This prospective, randomized clinical trial involved 336 patients. Anesthesia was induced with fentanyl and propofol and either 1.5 mg/kg rapacuronium or 1.0 mg/kg succinylcholine. The goal was to accomplish tracheal intubation by 60 s after administration of the neuromuscular blocking drug. Endotracheal intubation was performed, and conditions were graded by a blinded investigator. Recovery of neuromuscular function was assessed by electromyography.
Intubation conditions were evaluated in 236 patients. Intubation by 60 s after drug administration occurred in 100% of patients with rapacuronium and in 98% with succinylcholine. Intubation conditions were excellent or good in 87% of patients with rapacuronium and in 95% with succinylcholine (P < 0.05). The time (median and range) to the first recovery of the train-of-four response was 8.0 (2.8-20.0) min with rapacuronium and 5.7 (1.8-17.7) min with succinylcholine (P < 0.05). The overall incidence of adverse effects was similar with both drugs.
A 1.5-mg/kg dose of rapacuronium effectively facilitates rapid tracheal intubation. It can be considered a valid alternative to 1.0 mg/kg succinylcholine for this purpose.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott</pub><pmid>10551582</pmid><doi>10.1097/00000542-199911000-00023</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Anesthesiology (Philadelphia), 1999-11, Vol.91 (5), p.1311-1317 |
| issn | 0003-3022 1528-1175 |
| language | eng |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; Journals@Ovid Complete |
| subjects | Adolescent Adult Aged Aged, 80 and over Aging - physiology Anesthetics, Combined - adverse effects Anesthetics, Intravenous Anesthetics. Neuromuscular blocking agents Biological and medical sciences Blood Pressure - drug effects Female Fentanyl Heart Rate - drug effects Humans Intubation, Intratracheal Male Medical sciences Middle Aged Neuromuscular Blocking Agents - adverse effects Neuropharmacology Pharmacology. Drug treatments Propofol Prospective Studies Succinylcholine - adverse effects Vecuronium Bromide - adverse effects Vecuronium Bromide - analogs & derivatives |
| title | Comparison of the Intubation conditions provided by rapacuronium (ORG 9487) or succinylcholine in humans during anesthesia with fentanyl and propofol |
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