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Circulating Adhesion Molecule in Ex-Vivo Lung Perfusion Predicts Primary Graft Dysfunction. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Outcomes of Lung Transplantation Using Donation after Cardiac Death Donors: Should We Use Ex Vivo Lung Perfusion? J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.721] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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53
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Bile Acid, Not pH Probe or Gastrin Predicts Allograft Function at One Year, From the Prospective RESULT (Reflux Surgery in Lung Transplantation). J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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54
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Variations in Composition of Human Gastric Fluid: Implications for Monitoring Pulmonary Aspiration. J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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55
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Impact of cytokine expression in the pre-implanted donor lung on the development of chronic lung allograft dysfunction subtypes. Am J Transplant 2013; 13:3192-201. [PMID: 24164971 DOI: 10.1111/ajt.12492] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Revised: 08/13/2013] [Accepted: 09/07/2013] [Indexed: 01/25/2023]
Abstract
The long-term success of lung transplantation continues to be challenged by the development of chronic lung allograft dysfunction (CLAD). The purpose of this study was to investigate the relationship between cytokine expression levels in pre-implanted donor lungs and the posttransplant development of CLAD and its subtypes, bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome (RAS). Of 109 patients who underwent bilateral lung or heart-lung transplantation and survived for more than 3 months, 50 BOS, 21 RAS and 38 patients with No CLAD were identified by pulmonary function test results. Using donor lung tissue biopsies sampled from each patient, expression levels of IL-6, IL-1β, IL-8, IL-10, interferon-γ and tumor necrosis factor-α mRNA were measured. IL-6 expression levels were significantly higher in pre-implanted lungs of patients that ultimately developed BOS compared to RAS and No CLAD (p = 0.025 and 0.011, respectively). Cox regression analysis demonstrated an association between high IL-6 expression levels and BOS development (hazard ratio = 4.98; 95% confidence interval = 2.42-10.2, p < 0.001). In conclusion, high IL-6 mRNA expression levels in pre-implanted donor lungs were associated with the development of BOS, not RAS. This association further supports the contention that early graft injury impacts on both late graft function and early graft function.
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Apoptosis, Not Necrosis, during Ex-Vivo Lung Perfusion Is Correlated with Severe PGD. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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58
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Osteopontin Lung Expression Is a Marker of Disease Severity in Pulmonary Arterial Hypertension. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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59
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Outcomes Associated Mycobacterium xenopi (M. xenopi) Infections in Lung Transplant Recipients (LTRs). J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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60
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Improved Survival with Perioperative Desensitization in Lung Transplant Patients with Donor Specific Antibodies (DSA). J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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61
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Long-Term Results of Transplantation of Normothermic Ex-Vivo Perfused Donor Lungs. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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62
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Backyard poultry raising in Bangladesh: a valued resource for the villagers and a setting for zoonotic transmission of avian influenza. A qualitative study. Rural Remote Health 2012; 12:1927. [PMID: 22950607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
INTRODUCTION Backyard poultry raising is common in rural communities and a valued resource that provides food and income for subsistence farmers. Close contact with infected backyard poultry has been associated with H5N1 human cases in different countries. The emergence of this virus within Bangladesh means that backyard poultry raisers are at risk of avian influenza infections. The aim of this study was to understand why people raise backyard poultry and to characterize people's regular interaction with their poultry. METHODS In 2008, a qualitative study was conducted in two villages from two districts of Bangladesh. In a social mapping exercise the villagers drew all the households in their village: 115 households in the village in Netrokona and 85 households in the village in Rajshahi District. Selected were 40 households (20 households from each of the two villages) for data collection through in-depth interviews (n=40) and household mapping (n=40), and observation sessions (n=16). RESULTS In both villages, 92% of households raised backyard poultry. The majority of the owners was female and used the money earned from poultry raising to purchase cooking ingredients, clothing, and agricultural seeds, and pay for children's education expenses. The households consumed poultry meat and eggs. In the village in Netrokona, 80% (85/106) of households kept poultry inside the bedroom. In the village in Rajshahi, 87% (68/78) of households had separate cage/night sheds. During feeding the poultry and cleaning the poultry raising areas, villagers came into contact with poultry and poultry feces. Poultry scavenged for food on the floor, bed, in the food pot and around the place where food was cooked. Poultry drank from and bathed in the same body of water that villagers used for bathing and washing utensils and clothes. CONCLUSION Although raising poultry provides essential support to the families' livelihoods, it exposes them to the risk of avian influenza through close contact with their poultry. Simple warnings to avoid poultry contact are unlikely to change practices that are essential to household survival. Interventions that help to protect poultry flocks and improve household profitability are more likely to be practiced.
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Abstract
Voriconazole is commonly used for prophylaxis and treatment of invasive aspergillosis in lung transplant recipients. However, the use of voriconazole may at times be limited by the development of hepatotoxicity. Our goal is to determine predictors of voriconazole-associated hepatotoxicity in lung transplant recipients. We conducted a single center retrospective cohort study of lung transplant recipients from 2006 to 2010 who received voriconazole therapy. We compared characteristics of patients who developed hepatotoxicity and those who did not. One hundred five lung transplant recipients received voriconazole. Hepatotoxicity occurred in 51% (54/105) of patients and lead to discontinuation in 34% (36/105). In univariate analysis, age less than 40 years, cystic fibrosis, use of azathioprine, history of liver disease and early initiation of voriconazole were associated with hepatotoxicity. In multivariable logistic regression analysis, perioperative initiation of voriconazole (within 30 days of transplantation) was independently associated with hepatotoxicity (OR 4.37, 95% CI: 1.53-12.43, p = 0.006). The five risk factors identified in the univariate analysis were used to build a K-nearest neighbor algorithm predictive model for hepatotoxicity. This model predicted hepatotoxicity with an accuracy of 70%. Voriconazole therapy initiated within the first 30 days of transplantation is associated with a greater risk of developing hepatotoxicity.
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689 Diagnosis of Invasive Apsergillosis (Ia) in Explanted Lung Is Not Associated with Poor Outcome at One Year in Lung Transplant Recipients (Ltr). J Heart Lung Transplant 2012. [DOI: 10.1016/j.healun.2012.01.704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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65
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433 Risk Factors for Voriconazole Hepatotoxicity in Lung Transplant Recipients. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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66
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613 An LC-MS Method for Quantifying Bile Acid Species in Bronchial Washings of Lung Transplant Patients. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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67
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1 One Year Survival and Functional Status of Patients from the Human Ex Vivo Lung Perfusion (HELP) Trial. J Heart Lung Transplant 2011. [DOI: 10.1016/j.healun.2011.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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258: Ex Vivo Lung Perfusion in Clinical Lung Transplantation – The “HELP” Trial. J Heart Lung Transplant 2010. [DOI: 10.1016/j.healun.2009.11.270] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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69
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Balloon dilation of the pulmonary valve in premature infants with tetralogy of Fallot. Pediatr Cardiol 2008; 29:946-9. [PMID: 18663512 DOI: 10.1007/s00246-008-9247-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2007] [Revised: 05/05/2008] [Accepted: 05/15/2008] [Indexed: 10/21/2022]
Abstract
Infants with tetralogy of Fallot (ToF) presenting with desaturation may require augmentation of the pulmonary blood flow, usually in the form of a Blalock-Taussig shunt. Shunts may result in a preferential increase in blood flow to one lung. They also may be associated with significant morbidity and possibly mortality of premature infants. Balloon dilation of the pulmonary valve is reported to improve saturation in early infancy. This report describes two premature infants (weighing, respectively, 1.8 and 1.6 kg) with ToF and desaturation for whom balloon dilation of the pulmonary valve showed good results. Neither infant required palliative surgery. At this writing, one infant has already undergone complete repair.
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Das Münchner Rücken-Intensiv-Programm (MÜRIP). Prospektive Studie zur Evaluation eines ambulanten multimodalen Rehabilitationsprogramms für Patienten mit chronischen Rückenschmerzen. PHYSIKALISCHE MEDIZIN REHABILITATIONSMEDIZIN KURORTMEDIZIN 2008. [DOI: 10.1055/s-2008-1061761] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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71
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Temporary henna tattooing in siblings—An unusual chemical burn. Burns 2006; 32:1064-5. [PMID: 17010525 DOI: 10.1016/j.burns.2006.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2005] [Accepted: 04/06/2006] [Indexed: 11/21/2022]
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72
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Abstract
Debridement of linear burns especially on the trunk and abdomen can be challenging. Some currently used methods are technically difficult and potentially hazardous to the surgeon or the assistant. We propose a simple and effective method of linear burn debridement using towel clips. A pair of strong towel clips can be used to grasp the area of the burn at either end producing a tenting effect and therefore facilitating debridement of difficult areas. This technique provides a simple, precise and safe method of linear burn debridement.
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73
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Aortico-left ventricular tunnel: echocardiographic recognition. Indian Heart J 2006; 58:166-168. [PMID: 18989066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
Aortico-left ventricular tunnel (ALVT) is a rare congenital malformation characterized by an abnormal communication between aorta and left ventricular cavity and the child presents with features of congestive heart failure in early infancy. We report the case of a 7-day-old baby who was diagnosed as a case of ALVT by echocardiography. The child was operated successfully and echocardiographic findings were confirmed.
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74
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An unusual burn with varnish: a case report. Burns 2005; 31:933-4. [PMID: 16046075 DOI: 10.1016/j.burns.2005.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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75
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An adherent dressing for aplasia cutis congenita. ACTA ACUST UNITED AC 2005; 58:1159-61. [PMID: 16039625 DOI: 10.1016/j.bjps.2005.04.046] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2004] [Revised: 02/14/2005] [Accepted: 04/29/2005] [Indexed: 11/17/2022]
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Laser-Doppler-gestützte Kontrolle der Sympathikolyse nach kontinuierlicher axillärer Plexusanalgesie bei Patienten mit CRPS I. Anasthesiol Intensivmed Notfallmed Schmerzther 2005; 40:345-9. [PMID: 15942853 DOI: 10.1055/s-2005-861244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate continuous brachial plexus analgesia in terms of pain relief and sympathicolysis in patients suffering from CRPS I. METHODS A detailed clinical examination comprised measurement of temperature changes (Infrared Thermometry), pain rating (VAS scale) and assessment of peripheral sympathetic nervous function using laser Doppler flowmetry. A total number of 12 patients (mean age: 56 +/- 9 years, range: 30 to 69 years) received continuous brachial plexus analgesia after placing a catheter in the perineurial sheath of the brachial plexus through an axillary approach. Prior to continuous analgesia (Morphin 0.04 mg/ml, Clonidin 1.5 microg/ml, Bupivacaine 0.0625 %) running at 4 ml/h a test dosis of 20 ml Bupivacaine 0.25 % was applied to establish brachial plexus block. RESULTS After an equilibration period of 2 hours, consecutive pain measurements revealed sufficient pain relief in 9 out of 12 patients (75 %) with a mean pain rating dropping from 4.7 +/- 0.68 to 1.59 +/- 1.02 (p < 0.001). Pain reduction was accompanied by a significant temperature increase from -0.78 degrees C to 1.7 degrees C (p < 0.05). However measurement of sympathetic function by laser Doppler flowmetry revealed that no significant sympathicolysis occurred. CONCLUSIONS The study shows that clinical investigation of temperature change is not reliable in the evaluation of sympathicolysis. This is of special interest in patients who are suspected of having sympathically maintained pain (SMP) and are treated by brachial plexus analgesia.
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Endocannabinoide sind an der Entstehung von Langzeit-Depression GABAerger Synapsen beteiligt – mögliche Bedeutung für die Extinktion aversiver Gedächtnisinhalte in der Amygdala. Anasthesiol Intensivmed Notfallmed Schmerzther 2005. [DOI: 10.1055/s-2005-861728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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79
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80
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Electronic and chemical properties of mixed-metal oxides: Adsorption and reaction of NO on SrTiO3(100). J Chem Phys 2003. [DOI: 10.1063/1.1539864] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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81
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'Sponge split' for underlying haematomas. BRITISH JOURNAL OF PLASTIC SURGERY 2003; 56:75. [PMID: 12706167 DOI: 10.1016/s0007-1226(02)00470-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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82
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Painless steroid injections for hypertrophic scars and keloids. BRITISH JOURNAL OF PLASTIC SURGERY 2002; 55:534. [PMID: 12479437 DOI: 10.1054/bjps.2002.3913] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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83
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A technical modification for effective fenestration of small split-skin grafts. BRITISH JOURNAL OF PLASTIC SURGERY 2002; 55:539. [PMID: 12479443 DOI: 10.1054/bjps.2002.3889] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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84
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85
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Modified application of alginate dressings on graft donor sites. BRITISH JOURNAL OF PLASTIC SURGERY 2002; 55:177-8. [PMID: 11987972 DOI: 10.1054/bjps.2001.3778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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86
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'Four-swab technique' for detecting bleeding following complicated breast reduction surgery. BRITISH JOURNAL OF PLASTIC SURGERY 2001; 54:735. [PMID: 11728127 DOI: 10.1054/bjps.2001.3710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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87
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88
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A technical refinement for removal of a ganglion. BRITISH JOURNAL OF PLASTIC SURGERY 2001; 54:465. [PMID: 11428789 DOI: 10.1054/bjps.2001.3603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
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89
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Abstract
The staining of skin by silver is termed argyria and is grey-blue in colour. This may be caused by a number of mechanisms such as ingestion and direct implantation. We report an unusual case, caused by an impacted earring, where the skin discoloration was not entirely typical of argyria. This may have been due to copper impurities present in the earring. The literature on the subject is also reviewed.
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Clinical and physiologic evaluation of stellate ganglion blockade for complex regional pain syndrome type I. Clin J Pain 2001; 17:94-100. [PMID: 11289093 DOI: 10.1097/00002508-200103000-00012] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The efficacy of peripheral sympathetic interruption after stellate ganglion blockade was assessed by a sympathetic function test. Results were compared with clinical signs such as temperature changes, pain reduction, and the development of Horner syndrome to evaluate the correlation with clinical investigations. DESIGN Stellate ganglion blockade with local anesthetics was carried out via an anterior paratracheal approach in 33 patients suffering from complex regional pain syndrome type I. Patients were examined before and after the procedure. For assessment of sympathetic nervous function, the vasoconstrictor response to sympathetic stimuli was assessed using laser Doppler flowmetry. Clinical parameters like surface temperature changes (thermography), pain relief (visual analogue scale), and Horner syndrome were monitored. RESULTS Twenty-three (70%) of 33 patients developed an increase in temperature difference between the treated hand and the contralateral hand of more than 1.5 degreesC after the procedure, which is a clinical sign of sympathicolysis. In 48% (n = 11) of these patients, the sympathetic function test showed an undisturbed sympathetic nervous function. In 10 patients, no significant increase in temperature difference was observed. Although these patients presented with a normal sympathetic vasoconstrictor response, 4 felt pain relief of more than 50%, suggesting a placebo effect. Only 7 patients with pain relief revealed both clinical sympathicolysis and extinguished sympathetic nervous function and qualified for sympathetically maintained pain. CONCLUSIONS Clinical investigation is not reliable in the assessment of stellate ganglion blockade. Proof of sympathetically maintained pain based on pain relief after stellate ganglion blockade is not conclusive.
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91
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Getting a registrar post in plastic surgery. West J Med 2000. [DOI: 10.1136/bmj.321.7265.s2-7265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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92
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On the Reaction Pathway for the Hydrogenation of Acetylene and Vinylidene on Pd(111). J Phys Chem B 2000. [DOI: 10.1021/jp993250e] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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93
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Abstract
The onset, maximal neuromuscular block, and duration of rocuronium were compared with atracurium and vecuronium during enflurane anesthesia. Sixty patients received rocuronium (80, 100, 120, or 160 micrograms/kg). Enflurane enhanced a rocuronium neuromuscular block in a dose-related manner; the ED50 was 104 +/- 11 and 83 +/- 7 micrograms/kg (SEM) during 1% and 2% enflurane anesthesia, respectively. Patients receiving atracurium (0.12 mg/kg) or vecuronium (0.02 mg/kg) were studied during 1% enflurane anesthesia until seven in each group qualified by achieving a maximal block between 85% and 97%. These patients were matched with each other and with patients who had received rocuronium. Seven groups of three patients (rocuronium, vecuronium, and atracurium) were obtained. The average difference in maximal block was less than 2% between matched patients. The ratio of dose used to achieve a similar final block suggests potency ratios of 1, 8.5, and 1.2 for rocuronium, vecuronium, and atracurium. Rocuronium's onset time (time from drug administration to 50%, 75%, and 90% of final block) was significantly faster than either of the other two muscle relaxants (P < 0.01). Time to 90% of final block was 1.35 min for rocuronium, 3.06 min for atracurium, and 3.71 min for vecuronium. Using these equipotent doses, atracurium also had a shorter time to develop neuromuscular block than vecuronium (P < 0.05). For these three intermediate duration neuromuscular blockers, speed of onset was inversely related to their potency, confirming a relationship that had been demonstrated for the long-acting drugs pancuronium, d-tubocuranine, and gallamine.
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