ROCURONIUM BROMIDE – ESMERON
DOI:
https://doi.org/10.58885/ijllis.v12i1.55.qiAbstract
Repeated neuromuscular-blocking agent administration lengthens the duration of action, and intraoperative use of high doses of neuromuscular-blocking agent may compromise respiratory security. We tested the main hypothesis that intermediate-acting neuromuscular-blocking agents are dose dependently associated with the risk of postoperative respiratory complications in a hospital-based registry study that took place between January 2022 and June 2022 on 70 patients that we worked with who received these medications. Additionally, we looked at the relationship between respiratory problems and the dose of neostigmine used to reverse neuromuscular blockers. We assessed the impact of proper neostigmine reversal on respiratory complications post hoc. Compared to low doses, high doses of neuromuscular-blocking drugs were linked to a higher risk of postoperative respiratory complications. A dose-dependent increase in the risk of postoperative respiratory complications was linked to neostigmine. According to post hoc analysis, the dose-dependent relationship between neuromuscular-blocking drugs and respiratory complications was eliminated by the proper neostigmine reversal. The risk of postoperative respiratory complications was dose-dependently correlated with the use of neuromuscular-blocking drugs. The risk of respiratory complications increased dose-dependently after neostigmine reversal. The exploratory data analysis, however, indicates that the proper use of neostigmine, guided by the results of the monitoring of neuromuscular transmission, can help eliminate the postoperative respiratory complications brought on by the use of neuromuscular-blocking drugs. For newborns and small infants, rocuronium should be administered in lower doses.
Keywords: respiratory complications, Esmeron, neostigmine, surgery, anesthetic, intubation, etc.
References
Lee S, Lee J, Lee S, et al. The Effect of Nicorandil on the Pharmacodynamics of Rocuronium. Korean Journal of Anesthesiology. 2006; 50(5): 567, doi: 10.4097/kjae.2006.50.5.567.
Mathew A, Sharma ANG, Ganapathi P, et al. Intraoperative hemodynamics with vecuronium bromide and rocuronium for maintenance under general anesthesia. Anesth Essays Res. 2016; 10(1): 59–64, doi: 10.4103/0259-1162.164740, indexed in Pubmed: 26957692.
Virmani S, Tempe DK, Datt V, et al. Effect of muscle relaxants on heart rate, arterial pressure, intubation conditions and onset of neuromuscular block in patients undergoing valve surgery. Ann Card Anaesth. 2006; 9(1): 37–43, indexed in Pubmed: 17699906.
Feldman, S. Neuromuscular Blockade. Butterworth-Heinemann, 1996. Excellent chapters on neuromuscular transmission, acetylcholine pharmacology and mechanism of muscle relaxant actions.
Internet sites
https://en.wikipedia.org/wiki/Rocuronium_bromide
https://www.asahq.org/madeforthismoment/preparing-for-surgery/procedures/c-section/
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