1
|
Sakata H, Ishikawa Y, Ishihara G, Oyama N, Itami T, Umar MA, Sano T, Yamashita K. Effect of sevoflurane anesthesia on neuromuscular blockade produced by rocuronium infusion in dogs. J Vet Med Sci 2019; 81:425-433. [PMID: 30700651 PMCID: PMC6451902 DOI: 10.1292/jvms.18-0479] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study evaluated the effect of sevoflurane anesthesia on neuromuscular blockade with rocuronium in dogs. Six healthy beagle dogs were anesthetized four times with a minimum 14-day
washout period. On each occasion, the dogs were administered 1.25-, 1.5-, 1.75-, or 2.0-fold of the individualized minimum alveolar concentration (MAC) of sevoflurane and received an
infusion of rocuronium (0.5 mg/kg followed by 0.2 mg/kg/hr) for 120 min. Neuromuscular function was monitored with acceleromyography and train-of-four (TOF) stimulation of the left hind
limb. Time to achieve TOF count 0 (onset time), time from the onset of neuromuscular blockade to the reappearance of TOF count 4 (blockade period), and time from the onset of rocuronium
infusion to attaining a 70 or 90% TOF ratio (TOFR70 or TOFR90) were recorded. There were no significant differences in the onset time, blockade period, and plasma
rocuronium concentration between the sevoflurane MAC multiples. The TOFR70 and TOFR90 were dose-dependently prolonged with the sevoflurane MAC multiples. There were
significant differences in the TOFR70 and TOFR90 between the 1.25 sevoflurane MAC (median: 55 and 77.5 min, respectively) and 1.75 sevoflurane MAC (122.0 and 122.6 min;
P=0.020 and P=0.020, respectively), 1.25 sevoflurane MAC and 2.0 sevoflurane MAC (126.0 and 131.4 min; P=0.020 and
P=0.020), and 1.5 sevoflurane MAC (97.5 and 121.3 min) and 2.0 sevoflurane MAC (P=0.033 and P=0.032). In dogs, sevoflurane anesthesia
produced dose-dependent prolongation of recovery from neuromuscular blockade produced by rocuronium.
Collapse
Affiliation(s)
- Hisashi Sakata
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan
| | - Yushun Ishikawa
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan
| | - Genki Ishihara
- Anicom Specialty Medical Institute, Inc., Nishi-Shinjuku, Tokyo 160-0023, Japan
| | - Norihiko Oyama
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan
| | - Takaharu Itami
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan
| | - Mohammed Ahmed Umar
- Department of Veterinary Surgery and Radiology, Faculty of Veterinary Medicine, University of Maiduguri, Maiduguri, Borno State, Nigeria
| | - Tadashi Sano
- Department of Veterinary Nursing Science, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan
| | - Kazuto Yamashita
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan
| |
Collapse
|
2
|
Haga HA, Bettembourg V, Lervik A. Rocuronium infusion: A higher rate is needed in diabetic than nondiabetic dogs. Vet Anaesth Analg 2019; 46:28-35. [DOI: 10.1016/j.vaa.2018.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 06/18/2018] [Accepted: 07/03/2018] [Indexed: 10/28/2022]
|
3
|
Herway ST, Pollock K, Fairbanks KE, Benumof JL. Diffuse Limb Discoloration with Indigotindisulfonate (Indigo Carmine®) and the Associated Implications. ACTA ACUST UNITED AC 2016; 6:196-8. [PMID: 26795909 DOI: 10.1213/xaa.0000000000000280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Anesthesiologists often administer medications through an IV catheter that is distal to a noninvasive blood pressure (NIBP) cuff. We report 2 cases where indigotindisulfonate (Indigo Carmine) was administered through an IV catheter distal to an NIBP cuff. NIBP cuff inflation after indigotindisulfonate administration resulted in diffuse limb discoloration distal to the NIBP cuff although the IV catheter remained completely within the intact vein. These cases suggest that administration of medications that have the same physical characteristics as indigotindisulfonate under the same conditions (i.e., proximal venous occlusion) could also result in an interstitial distribution of these drugs.
Collapse
Affiliation(s)
- Seth T Herway
- From the Department of Anesthesiology, University of California, San Diego, California
| | | | | | | |
Collapse
|
4
|
Rezonja K, Sostaric M, Vidmar G, Mars T. Dexamethasone produces dose-dependent inhibition of sugammadex reversal in in vitro innervated primary human muscle cells. Anesth Analg 2014; 118:755-63. [PMID: 24651229 DOI: 10.1213/ane.0000000000000108] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Corticosteroids are frequently used during anesthesia to provide substitution therapy in patients with adrenal insufficiency, as a first-line treatment of several life-threatening conditions, to prevent postoperative nausea and vomiting, and as a component of multimodal analgesia. For these last 2 indications, dexamethasone is most frequently used. Due to the structural resemblance between aminosteroid muscle relaxants and dexamethasone, concerns have been raised about possible corticosteroid inhibition in the reversal of neuromuscular block by sugammadex. We thus investigated the influence of dexamethasone on sugammadex reversal of rocuronium-induced neuromuscular block, which could be relevant in certain clinical situations. METHODS The unique co-culture model of human muscle cells innervated in vitro with rat embryonic spinal cord explants to form functional neuromuscular junctions was first used to explore the effects of 4 and 10 μM rocuronium on muscle contractions, as quantitatively evaluated by counting contraction units in contraction-positive explant co-cultures. Next, equimolar and 3-fold equimolar sugammadex was used to investigate the recovery of contractions from 4 and 10 μM rocuronium block. Finally, 1, 100, and 10 μM dexamethasone (normal, elevated, and high clinical levels) were used to evaluate any effects on the reversal of rocuronium-induced neuromuscular block by sugammadex. RESULTS Seventy-eight explant co-cultures from 3 time-independent experiments were included, where the number of contractions increased to 10 days of co-culturing. Rocuronium showed a time-dependent effect on depth of neuromuscular block (4 μM rocuronium: baseline, 10, 20 minutes administration; P < 0.0001), while the dose-dependent effect was close to nominal statistical significance (4, 10 μM; P = 0.080). This was reversed by equimolar concentrations of sugammadex, with further and virtually complete recovery of contractions with 3-fold equimolar sugammadex (P < 0.0001). Dexamethasone diminished 10 μM sugammadex-induced recovery of contractions from rocuronium-induced neuromuscular block in a dose-dependent manner (P = 0.026) with a higher sugammadex concentration (30 μM) being close to statistically significantly improving recovery (P = 0.065). The highest concentration of dexamethasone decreased the recovery of contractions by equimolar sugammadex by 26%; this effect was more pronounced when 3-fold equimolar (30 μM) sugammadex was used for reversal (48%). CONCLUSIONS This is the first report in which the effects of rocuronium and sugammadex interactions with dexamethasone have been studied in a highly accessible in vitro experimental model of functionally innervated human muscle cells. Sugammadex reverses rocuronium-induced neuromuscular block; however, concomitant addition of high dexamethasone concentrations diminishes the efficiency of sugammadex. Further studies are required to determine the clinical relevance of these interactions.
Collapse
Affiliation(s)
- Katja Rezonja
- From the *Department of Anesthesiology and Intensive Therapy, University Medical Centre Ljubljana; and †Institute for Biostatistics and Medical Informatics and ‡Institute of Pathophysiology, University of Ljubljana, Ljubljana, Slovenia
| | | | | | | |
Collapse
|
5
|
Gorynski K, Bojko B, Kluger M, Jerath A, Wąsowicz M, Pawliszyn J. Development of SPME method for concomitant sample preparation of rocuronium bromide and tranexamic acid in plasma. J Pharm Biomed Anal 2014; 92:183-92. [PMID: 24525565 DOI: 10.1016/j.jpba.2014.01.026] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 01/15/2014] [Accepted: 01/19/2014] [Indexed: 11/19/2022]
Abstract
A high-throughput method using solid-phase microextraction coupled to liquid chromatography-tandem mass spectrometry (SPME-LC-MS/MS) for determination of tranexamic acid and rocuronium bromide in human plasma was developed and validated. Standard analytical approaches employ acidification of the sample due to the instability of rocuronium bromide in collected plasma samples. However, acidification affects the binding equilibrium of the drug and consequently no information on the free/bound concentration can be obtained. Contrary to these protocols, the proposed method requires minimum sample handling and no ion pairing and/or derivatization procedure. A weak cation exchange coating was chosen as the best extracting phase for selected drugs, guaranteed a good recovery, minimum carry-over, reusability and reproducibility. SPME procedure met all Food and Drug Administration acceptance criteria for bioanalytical assays at three concentration levels, for both selected drugs. Post-extraction addition experiments showed that matrix effect was less than ±3%. Here, a weak cation exchange thin-film solid-phase microextraction (WCX TF-SPME) approach is presented, offering effective cleanup procedure and full quantitation of the drugs in plasma, undoubtedly one the most challenging matrices with regards to its complexity. In addition, the 96-well plate format of WCX TF-SPME system provides considerable advantages, such as high throughput analysis for up to 96 samples in 35min (22s/sample), requirement of small amounts of plasma samples (0.8mL), and a simple sample preparation protocol, all of which shows a promise for possible on-site application in hospitals to monitor concentrations of the drugs in close to real time.
Collapse
Affiliation(s)
- Krzysztof Gorynski
- Department of Chemistry, University of Waterloo, Waterloo, ON, Canada N2L 3G1; Department of Medicinal Chemistry, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Jurasza 2, 85-089 Bydgoszcz, Poland
| | - Barbara Bojko
- Department of Chemistry, University of Waterloo, Waterloo, ON, Canada N2L 3G1; Department of Medicinal Chemistry, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Jurasza 2, 85-089 Bydgoszcz, Poland
| | - Michael Kluger
- Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, ON, Canada M5G 2C4
| | - Angela Jerath
- Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, ON, Canada M5G 2C4; Department of Anesthesia, Faculty of Medicine, University of Toronto, Canada
| | - Marcin Wąsowicz
- Department of Anesthesia and Pain Management, Toronto General Hospital, Toronto, ON, Canada M5G 2C4; Department of Anesthesia, Faculty of Medicine, University of Toronto, Canada
| | - Janusz Pawliszyn
- Department of Chemistry, University of Waterloo, Waterloo, ON, Canada N2L 3G1.
| |
Collapse
|
6
|
Kalkan Y, Bostan H, Tumkaya L, Tomak Y, Bostan M, Yilmaz A, Turut H, Temiz A, Yalçin A, Turan A. The effect of rocuronium, sugammadex, and their combination on cardiac muscle and diaphragmatic skeletal muscle cells. J Anesth 2012; 26:870-7. [DOI: 10.1007/s00540-012-1440-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Accepted: 06/13/2012] [Indexed: 12/17/2022]
|
7
|
Weiss M, Reekers M, Vuyk J, Boer F. Circulatory model of vascular and interstitial distribution kinetics of rocuronium: a population analysis in patients. J Pharmacokinet Pharmacodyn 2010; 38:165-78. [DOI: 10.1007/s10928-010-9186-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2010] [Accepted: 11/13/2010] [Indexed: 11/29/2022]
|
8
|
Feasibility of Microdialysis to Determine Interstitial Rocuronium Concentration in the Muscle Tissue of Anesthetized Neurosurgical Patients. J Neurosurg Anesthesiol 2010; 22:163-9. [DOI: 10.1097/ana.0b013e3181c80a68] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
9
|
Lestari MLAD, Indrayanto G. Rocuronium bromide. PROFILES OF DRUG SUBSTANCES, EXCIPIENTS, AND RELATED METHODOLOGY 2010; 35:285-308. [PMID: 22469224 DOI: 10.1016/s1871-5125(10)35006-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
|
10
|
Cao G, Cai H, Cong X, Zhang Y, Shao Y, Cai B. Application of Microdialysis for Pharmacokinetics of Traditional Chinese Medicine Studies. ANAL LETT 2010. [DOI: 10.1080/00032710903201958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
11
|
Chen C, Yamaguchi N, Varin F. Dose-dependency of pharmacokinetic/pharmacodynamic parameters after intravenous bolus doses of cisatracurium. Br J Anaesth 2008; 101:788-97. [DOI: 10.1093/bja/aen308] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
|
12
|
Alderson B, Senior JM, Jones RS, Dugdale AHA. Use of rocuronium administered by continuous infusion in dogs. Vet Anaesth Analg 2007; 34:251-6. [PMID: 17490469 DOI: 10.1111/j.1467-2995.2006.00307.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE A clinical trial to determine whether continuous infusion administration technique was suitable for maintaining neuromuscular blockade with rocuronium bromide in dogs. ANIMALS Twenty-two dogs, 10 males and 12 females, median age 2 years 4 months, median weight 32 kg undergoing elective surgical procedures under general anaesthesia: ASA classification I or II. MATERIALS AND METHODS After induction of anaesthesia, neuromuscular function was evaluated using train-of-four (TOF) stimulation of the dorsal buccal branch of the facial nerve. A bolus dose of 0.5 mg kg(-1) rocuronium was administered intravenously and an infusion of 0.2 mg kg(-1) hour(-1) was started immediately. Neuromuscular blockade was assessed visually by counting the number of twitches observed during TOF stimulation repeated at 10-second intervals. RESULTS The bolus dose of rocuronium abolished the response to TOF stimulation in 21 of the 22 dogs. The median onset time of neuromuscular blockade (complete loss of all four twitches) was 82 seconds (range 38-184 seconds). Median infusion duration was 76 minutes (range 20.3-146 minutes). CONCLUSIONS AND CLINICAL RELEVANCE This protocol of rocuronium administration was considered to be effective in dogs. Constant infusion of rocuronium is easily applicable to clinical practice and further work is required on infusion titration.
Collapse
Affiliation(s)
- Briony Alderson
- The University of Liverpool Small Animal Referral Hospital, Liverpool, UK.
| | | | | | | |
Collapse
|
13
|
Höcht C, Opezzo JAW, Bramuglia GF, Taira CA. Application of microdialysis for pharmacokinetic-pharmacodynamic modelling. Expert Opin Drug Discov 2006; 1:289-301. [DOI: 10.1517/17460441.1.4.289] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
14
|
Höcht C, DiVerniero C, Opezzo JAW, Taira CA. Applicability of microdialysis as a technique for pharmacokinetic-pharmacodynamic (PK-PD) modeling of antihypertensive beta-blockers. J Pharmacol Toxicol Methods 2006; 52:244-50. [PMID: 16125622 DOI: 10.1016/j.vascn.2005.01.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2004] [Accepted: 01/18/2005] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The aim of the present work was to examine microdialysis as a technique for the study of pharmacokinetic-pharmacodynamic modeling of antihypertensive drugs. For this purpose, we studied the antihypertensive and the chronotropic effect of metoprolol and its plasma concentrations in sham operated (SO) and aortic coarctated (ACo) rats at an early hypertensive stage. METHODS Plasma metoprolol concentrations were obtained by means of a "shunt" vascular microdialysis probe. Changes in mean arterial pressure and heart rate were also measured in the same experiment. RESULTS A rapid decay of metoprolol levels was observed in both experimental groups. For the chronotropic effect, a good association between plasma levels and the chronotropic effect was observed in SO and ACo rats. ACo rats had a greater sensitivity to the chronotropic effect (Emax:-38+/-2%, n=5, p<0.05) than SO animals (Emax:-27+/-1%, n=5). A delay in the blood pressure reduction induced by metoprolol was observed in both experimental groups. A good association was observed between concentrations of metoprolol in the effect compartment and the corresponding hypotensive effect in both experimental groups. The calculated PK-PD parameters were not different between SO and ACo groups. DISCUSSION A good correlation was found between metoprolol concentration and its chronotropic and antihypertensive effects in normotensive and ACo hypertensive rats, allowing the employment of PK-PD models. The microdialysis technique allows simultaneous determination of plasma levels of antihypertensive drugs and their cardiovascular effects, and is therefore a powerful tool for PK-PD modeling.
Collapse
Affiliation(s)
- Christian Höcht
- Cátedra de Farmacología, Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Batalla de Junín 956, C1113AAD Buenos Aires, Argentina.
| | | | | | | |
Collapse
|