A pharmacokinetic explanation for increasing recovery time following larger or repeated doses of nondepolarizing muscle relaxants.

Abstract:

:The authors used pharmacokinetic and pharmacodynamic modeling to explain the time course of neuromuscular blockade following single or multiple doses of three nondepolarizing muscle relaxants. Published and unpublished pharmacokinetic and pharmacodynamic data for 13 normal subjects were used to simulate the duration of neuromuscular blockade (time from administration of the muscle relaxant to 25% recovery of control twitch tension) following six successive doses of atracurium (150-400 micrograms/kg initially, followed by 100 micrograms/kg), vecuronium, or pancuronium (30-80 micrograms/kg initially, followed by 20 micrograms/kg). With atracurium, duration of action was similar for the second and sixth doses, regardless of the initial dose. With vecuronium (initial doses of 30-80 micrograms/kg) and pancuronium (initial doses of 30-60 micrograms/kg), duration of action was longer after the sixth dose than after the second; with larger initial doses of pancuronium (70 and 80 micrograms/kg), duration of action was similar following the second and sixth doses. The authors also determined two recovery times (time for twitch tension to recover from 5-25% and from 25-75% of control value) for varying single doses of atracurium, vecuronium, or pancuronium. When the dose of atracurium was increased from 200 to 400 micrograms/kg, neither recovery time increased. When the dose of vecuronium was increased from 40 to 80 micrograms/kg, 5-25% recovery time increased from 6.0 +/- 2.5 min to 8.8 +/- 4.0 min (mean +/- SD) and 25-75% recovery time increased from 8.7 +/- 4.3 min to 12.6 +/- 4.4 min.(ABSTRACT TRUNCATED AT 250 WORDS)

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

Fisher DM,Rosen JI

subject

Has Abstract

pub_date

1986-09-01 00:00:00

pages

286-91

issue

3

eissn

0003-3022

issn

1528-1175

journal_volume

65

pub_type

杂志文章
  • Predicting patient nonappearance for surgery as a scheduling strategy to optimize operating room utilization in a veterans' administration hospital.

    abstract:BACKGROUND:Previous attempts at improving operating room utilization have generally emphasized more accurate scheduling, starting the first case on time, and reducing turnover time. Surgical case cancellations have largely been ignored except for recommendations for preoperative screening and good physician-patient com...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200604000-00029

    authors: Basson MD,Butler TW,Verma H

    更新日期:2006-04-01 00:00:00

  • Nitrogen analyzer adaptation for use in the presence of halogenated anesthetics.

    abstract::Interposition of activated carbon between a nitrogen analyzer needle valve and gas mixtures containing halothane, methoxyflurane, enflurane, or isoflurane eliminated the interfering effects of these agents, but added sampling delays. Placement of a carbon-filled Swinney adaptor in the sampling line between the needle ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-197512000-00014

    authors: Gilmour IJ,Holland R,Craig DB

    更新日期:1975-12-01 00:00:00

  • Injuries and liability related to central vascular catheters: a closed claims analysis.

    abstract:BACKGROUND:To assess changing patterns of injury and liability associated with central venous or pulmonary artery catheters, the authors analyzed closed malpractice claims for central catheter injuries in the American Society of Anesthesiologists Closed Claims database. METHODS:All claims for which a central catheter ...

    journal_title:Anesthesiology

    pub_type: 杂志文章,评审

    doi:10.1097/00000542-200406000-00013

    authors: Domino KB,Bowdle TA,Posner KL,Spitellie PH,Lee LA,Cheney FW

    更新日期:2004-06-01 00:00:00

  • Resting metabolic rate of the critically ill patient: measured versus predicted.

    abstract::Critically ill patients requiring mechanical ventilation are particularly susceptible to malnutrition. A knowledge of the energy requirements of these patients is essential in designing nutritional regimens. This study examines 45 resting energy-expenditure measurements performed in a group (n = 40) of postoperative, ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198606000-00001

    authors: Weissman C,Kemper M,Askanazi J,Hyman AI,Kinney JM

    更新日期:1986-06-01 00:00:00

  • Obesity decreases perioperative tissue oxygenation.

    abstract:BACKGROUND:Obesity is an important risk factor for surgical site infections. The incidence of surgical wound infections is directly related to tissue perfusion and oxygenation. Fat tissue mass expands without a concomitant increase in blood flow per cell, which might result in a relative hypoperfusion with decreased ti...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200402000-00015

    authors: Kabon B,Nagele A,Reddy D,Eagon C,Fleshman JW,Sessler DI,Kurz A

    更新日期:2004-02-01 00:00:00

  • Effects of intravenous dexmedetomidine in humans. I. Sedation, ventilation, and metabolic rate.

    abstract::Dexmedetomidine (DMED) is a highly selective centrally acting alpha 2-adrenergic agonist thought to provide significant sedation without appreciable ventilatory effects. This double-blind, placebo-controlled experiment evaluated four dose levels of DMED (0.25, 0.5, 1.0, and 2.0 micrograms/kg intravenously over 2 min) ...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199212000-00013

    authors: Belleville JP,Ward DS,Bloor BC,Maze M

    更新日期:1992-12-01 00:00:00

  • Pentobarbital enhances GABAergic neurotransmission to cardiac parasympathetic neurons, which is prevented by expression of GABA(A) epsilon subunit.

    abstract:BACKGROUND:Pentobarbital decreases the gain of the baroreceptor reflex on the order of 50%, and this blunting is caused nearly entirely by decreasing cardioinhibitory parasympathetic activity. The most likely site of action of pentobarbital is the gamma-aminobutyric acid type A (GABA(A)) receptor. The authors tested wh...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200209000-00027

    authors: Irnaten M,Walwyn WM,Wang J,Venkatesan P,Evans C,Chang KS,Andresen MC,Hales TG,Mendelowitz D

    更新日期:2002-09-01 00:00:00

  • A comparison of obstetric and nonobstetric anesthesia malpractice claims.

    abstract::Malpractice claims filed against anesthesiologists for care involving obstetric (OB) anesthesia (n = 190) were taken from the American Society of Anesthesiologists' Closed Claims Database and compared to claims not involving OB cases (n = 1351). The most common complications in the OB claims were (percentage of all OB...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199102000-00009

    authors: Chadwick HS,Posner K,Caplan RA,Ward RJ,Cheney FW

    更新日期:1991-02-01 00:00:00

  • Toll-like receptor 4-myeloid differentiation factor 88 signaling contributes to ventilator-induced lung injury in mice.

    abstract:BACKGROUND:The mechanisms of ventilator-induced lung injury, an iatrogenic inflammatory condition induced by mechanical ventilation, are not completely understood. Toll-like receptor 4 (TLR4) signaling via the adaptor protein myeloid differentiation factor 88 (MyD88) is proinflammatory and plays a critical role in host...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e3181e89ab2

    authors: Li H,Su X,Yan X,Wasserloos K,Chao W,Kaynar AM,Liu ZQ,Leikauf GD,Pitt BR,Zhang LM

    更新日期:2010-09-01 00:00:00

  • High-sensitivity Cardiac Troponin Elevation after Electroconvulsive Therapy: A Prospective, Observational Cohort Study.

    abstract:BACKGROUND:While electroconvulsive therapy is widely regarded as a lifesaving and safe procedure, evidence regarding its effects on myocardial cell injury is sparse. The objective of this investigation was to determine the incidence and magnitude of new cardiac troponin elevation after electroconvulsive therapy using a...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000001531

    authors: Duma A,Pal S,Johnston J,Helwani MA,Bhat A,Gill B,Rosenkvist J,Cartmill C,Brown F,Miller JP,Scott MG,Sanchez-Conde F,Jarvis M,Farber NB,Zorumski CF,Conway C,Nagele P

    更新日期:2017-04-01 00:00:00

  • Rewarding electrical brain stimulation in rats after peripheral nerve injury: decreased facilitation by commonly abused prescription opioids.

    abstract:BACKGROUND:Prescription opioid abuse is a significant concern in treating chronic pain, yet few studies examine how neuropathic pain alters the abuse liability of commonly abused prescription opioids. METHODS:Normal and spinal nerve ligated (SNL) rats were implanted with electrodes into the left ventral tegmental area...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e3182330448

    authors: Ewan EE,Martin TJ

    更新日期:2011-12-01 00:00:00

  • Ineffectiveness of burst suppression therapy in mitigating perioperative cerebrovascular dysfunction. Multicenter Study of Perioperative Ischemia (McSPI) Research Group.

    abstract:BACKGROUND:Cerebral injury is among the most common and disabling complications of open heart surgery. Attempts to provide neuroprotection have yielded conflicting results. We assessed the potential of propofol-induced burst suppression during open heart surgery to provide cerebral protection as determined by postopera...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1097/00000542-199905000-00006

    authors: Roach GW,Newman MF,Murkin JM,Martzke J,Ruskin A,Li J,Guo A,Wisniewski A,Mangano DT

    更新日期:1999-05-01 00:00:00

  • Mechanism of myocardial protection by isoflurane. Role of adenosine triphosphate-regulated potassium (KATP) channels.

    abstract:BACKGROUND:The mechanism of the protective actions of volatile anesthetics in ischemic myocardium has not been clearly elucidated. The role of myocardial adenosine triphosphate-regulated potassium (KATP) channels in isoflurane-induced enhancement of recovery of regional contractile function after multiple brief occlusi...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199610000-00015

    authors: Kersten JR,Schmeling TJ,Hettrick DA,Pagel PS,Gross GJ,Warltier DC

    更新日期:1996-10-01 00:00:00

  • Microinjection of an adenosine A1 agonist into the medial pontine reticular formation increases tail flick latency to thermal stimulation.

    abstract:BACKGROUND:Both pain and the pharmacologic management of pain can cause the undesirable effect of sleep disruption. One goal of basic and clinical neuroscience is to facilitate rational drug development by identifying the brain regions and neurochemical modulators of sleep and pain. Adenosine is thought to be an endoge...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200212000-00036

    authors: Tanase D,Baghdoyan HA,Lydic R

    更新日期:2002-12-01 00:00:00

  • General Anesthesia Causes Long-term Impairment of Mitochondrial Morphogenesis and Synaptic Transmission in Developing Rat Brain.

    abstract:BACKGROUND:Clinically used general anesthetics, alone or in combination, are damaging to the developing mammalian brain. In addition to causing widespread apoptotic neurodegeneration in vulnerable brain regions, exposure to general anesthesia at the peak of synaptogenesis causes learning and memory deficiencies later i...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e3182303a63

    authors: Sanchez V,Feinstein SD,Lunardi N,Joksovic PM,Boscolo A,Todorovic SM,Jevtovic-Todorovic V

    更新日期:2011-11-01 00:00:00

  • Changing anesthesiologists' practice patterns. Can it be done?

    abstract:BACKGROUND:Because the ultimate purpose of new medical knowledge is to achieve improved health outcomes, physicians need to possess and use this knowledge in their practice. The authors introduced enhanced education and individualized feedback to reduce postoperative nausea and vomiting (PONV). The primary objective wa...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000542-199608000-00006

    authors: Cohen MM,Rose DK,Yee DA

    更新日期:1996-08-01 00:00:00

  • Propofol suppresses macrophage functions and modulates mitochondrial membrane potential and cellular adenosine triphosphate synthesis.

    abstract:BACKGROUND:Propofol is an intravenous anesthetic agent that may impair host defense system. The aim of this study was to evaluate the effects of propofol on macrophage functions and its possible mechanism. METHODS:Mouse macrophage-like Raw 264.7 cells were exposed to propofol, at 3, 30 (a clinically relevant concentra...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200305000-00021

    authors: Chen RM,Wu CH,Chang HC,Wu GJ,Lin YL,Sheu JR,Chen TL

    更新日期:2003-05-01 00:00:00

  • Effects of isoflurane on ouabain toxicity in canine Purkinje fibers. Comparison with halothane.

    abstract:BACKGROUND:Although halothane reduces digitalis toxicity, other anesthetics, notably cyclopropane, increase toxicity. This study determined the effects of isoflurane on digitalis toxicity in isolated cardiac tissue and compared these effects with those of halothane. METHODS:Standard microelectrode techniques were used...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199412000-00026

    authors: Gallagher JD

    更新日期:1994-12-01 00:00:00

  • Hemodynamic interactions of verapamil and isoflurane.

    abstract::The hemodynamic interactions of verapamil and isoflurane were studied in eight dogs. Left ventricular function was analyzed using a right heart bypass preparation to permit rigid hemodynamic control. Hemodynamic studies were performed at 0.7, 1.05, and 1.40% isoflurane before and during the maintenance of two stable l...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198308000-00012

    authors: Kates RA,Kaplan JA,Guyton RA,Dorsey L,Hug CC Jr,Hatcher CR

    更新日期:1983-08-01 00:00:00

  • Effects of positive end-expiratory pressure titration and recruitment maneuver on lung inflammation and hyperinflation in experimental acid aspiration-induced lung injury.

    abstract:BACKGROUND:In acute lung injury positive end-expiratory pressure (PEEP) and recruitment maneuver are proposed to optimize arterial oxygenation. The aim of the study was to evaluate the impact of such a strategy on lung histological inflammation and hyperinflation in pigs with acid aspiration-induced lung injury. METHO...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e31827542aa

    authors: Ambrosio AM,Luo R,Fantoni DT,Gutierres C,Lu Q,Gu WJ,Otsuki DA,Malbouisson LM,Auler JO Jr,Rouby JJ,Experimental ARDS Study Group.

    更新日期:2012-12-01 00:00:00

  • Neuropathic Allodynia Involves Spinal Neurexin-1β-dependent Neuroligin-1/Postsynaptic Density-95/NR2B Cascade in Rats.

    abstract:BACKGROUND:Neuroligin-1 (NL1) forms a complex with the presynaptic neurexin-1β (Nrx1b), regulating clustering of N-methyl-D-aspartate receptors with postsynaptic density-95 (PSD-95) to underlie learning-/memory-associated plasticity. Pain-related spinal neuroplasticity shares several common features with learning-/memo...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000809

    authors: Lin TB,Lai CY,Hsieh MC,Jiang JL,Cheng JK,Chau YP,Ruan T,Chen GD,Peng HY

    更新日期:2015-10-01 00:00:00

  • Effects of ondansetron in the prevention of postoperative nausea and vomiting in children.

    abstract:BACKGROUND:Postoperative nausea and vomiting (PONV) is a commonly observed adverse effect of general anesthesia. Recently, ondansetron, a new serotonin3 (5-hydroxytryptamine3) receptor antagonist was shown to be effective in the prophylaxis and prevention of chemotherapy-induced nausea and vomiting in children and adul...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199410000-00006

    authors: Ummenhofer W,Frei FJ,Urwyler A,Kern C,Drewe J

    更新日期:1994-10-01 00:00:00

  • Predicting difficult intubation with indirect laryngoscopy.

    abstract:BACKGROUND:It is not always possible to predict when tracheal intubation will be difficult or impossible. The authors wanted to determine whether indirect laryngoscopy could identify patients in whom intubation was difficult. METHODS:Indirect laryngoscopy was done in 2,504 patients. The Wilson risk sum score and the m...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199702000-00007

    authors: Yamamoto K,Tsubokawa T,Shibata K,Ohmura S,Nitta S,Kobayashi T

    更新日期:1997-02-01 00:00:00

  • Effect of combined mouth closure and chin lift on upper airway dimensions during routine magnetic resonance imaging in pediatric patients sedated with propofol.

    abstract:BACKGROUND:In pediatric patients, obstruction of the upper airway is a common problem during general anesthesia. Chin lift is a commonly used technique to improve upper airway patency. However, little is known about the mechanism underlying this technique. METHODS:The authors studied the effect of the chin lift maneuv...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199906000-00018

    authors: Reber A,Wetzel SG,Schnabel K,Bongartz G,Frei FJ

    更新日期:1999-06-01 00:00:00

  • Brain bioenergetics during cardiopulmonary resuscitation in dogs.

    abstract::Cardiac arrest causes a rapid loss of cerebral adenosine triphosphate [corrected] (ATP) and a decrease in cerebral intracellular pH (pHi). Depending on the efficacy of cardiopulmonary resuscitation (CPR), cerebral blood flow levels (CBF) ranging from near zero to near normal have been reported experimentally. Using 31...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199201000-00012

    authors: Eleff SM,Schleien CL,Koehler RC,Shaffner DH,Tsitlik J,Halperin HR,Rogers MC,Traystman RJ

    更新日期:1992-01-01 00:00:00

  • Astrocytes Protect against Isoflurane Neurotoxicity by Buffering pro-brain-derived Neurotrophic Factor.

    abstract:BACKGROUND:Isoflurane induces cell death in neurons undergoing synaptogenesis via increased production of pro-brain-derived neurotrophic factor (proBDNF) and activation of postsynaptic p75 neurotrophin receptor (p75). Astrocytes express p75, but their role in neuronal p75-mediated cell death remains unclear. The author...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000824

    authors: Stary CM,Sun X,Giffard RG

    更新日期:2015-10-01 00:00:00

  • Diagnostic Accuracy of Respiratory Distress Observation Scales as Surrogates of Dyspnea Self-report in Intensive Care Unit Patients.

    abstract:BACKGROUND:Dyspnea, like pain, can cause major suffering in intensive care unit (ICU) patients. Its evaluation relies on self-report; hence, the risk of being overlooked when verbal communication is impaired. Observation scales incorporating respiratory and behavioral signs (respiratory distress observation scales [RDO...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000805

    authors: Persichini R,Gay F,Schmidt M,Mayaux J,Demoule A,Morélot-Panzini C,Similowski T

    更新日期:2015-10-01 00:00:00

  • Dishabituation of mesencephalic reticular neurons by anesthetics.

    abstract::To determine whether neuronal firing is affected by anesthetics, the behavior of neurons in the mesencephalic reticular formation in response to repetitive somatosensory stimulation at 2/sec was studied during wakefulness and during nitrous oxide, halothane, and thiopental anesthesia in the cat. With clinical doses of...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-197710000-00005

    authors: Shimoji K,Matsuki M,Shimizu H,Maruyama Y,Aida S

    更新日期:1977-10-01 00:00:00

  • Are all preterm infants younger than 60 weeks postconceptual age at risk for postanesthetic apnea?

    abstract:BACKGROUND:Preterm and ex-preterm infants are at risk for life-threatening apnea after general anesthesia. The authors attempted to define the postconceptual age beyond which apnea is less likely to occur and to identify the factors that predispose to postanesthetic apnea. METHODS:Ninety-one infants younger than 60 we...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199306000-00009

    authors: Malviya S,Swartz J,Lerman J

    更新日期:1993-06-01 00:00:00

  • Local anesthetic properties of prenylamine.

    abstract:BACKGROUND:Local anesthetics that produce analgesia of long duration with minimal impairment of autonomic functions are highly desirable for pain management in the clinic. Prenylamine is a known calcium channel blocker, but its local anesthetic blocking effects on voltage-gated sodium channels have not been studied thu...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200111000-00025

    authors: Mujtaba MG,Gerner P,Wang GK

    更新日期:2001-11-01 00:00:00