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Context-sensitive recovery of neuromuscular function from vecuronium in dogs: Effects of dose and dosing protocol
•Increasing the dose of vecuronium prolonged the duration of relaxation but also slowed down the speed of spontaneous recovery.•Dividing the dose into smaller aliquots increased the duration of relaxation and shortened the recovery period.•The speed of recovery from neuromuscular block depended on t...
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Published in: | The veterinary journal (1997) 2019-06, Vol.248, p.14-17 |
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description | •Increasing the dose of vecuronium prolonged the duration of relaxation but also slowed down the speed of spontaneous recovery.•Dividing the dose into smaller aliquots increased the duration of relaxation and shortened the recovery period.•The speed of recovery from neuromuscular block depended on the dose of the blocker and how that dose was administered.
Recovery of neuromuscular function is a gradual phenomenon whereby function progresses from absent to normal. The speed of spontaneous recovery can be used to predict the time when neuromuscular function is expected to be restored. However, the speed of recovery might be affected by the dose of the neuromuscular blocker administered, and by the dosing regimen of that dose. The effects of both factors on the speed of spontaneous recovery from vecuronium were evaluated. Seven dogs were anesthetized three times and the train-of-four (TOF) ratio was measured with acceleromyography. Vecuronium was administered at 0.1 mg/kg, 0.2 mg/kg, or 0.1 mg/kg followed by two doses of 0.05 mg/kg was administered each time. In the divided-dose treatment group, aliquots were administered on return of the first twitch (T1) of the TOF from the previous dose.
The duration of surgical block, from injection to return of T1, was longest for the divided-dose protocol, intermediate for 0.2 mg/kg single bolus, and shortest for 0.1 mg/kg (P |
doi_str_mv | 10.1016/j.tvjl.2019.04.004 |
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Recovery of neuromuscular function is a gradual phenomenon whereby function progresses from absent to normal. The speed of spontaneous recovery can be used to predict the time when neuromuscular function is expected to be restored. However, the speed of recovery might be affected by the dose of the neuromuscular blocker administered, and by the dosing regimen of that dose. The effects of both factors on the speed of spontaneous recovery from vecuronium were evaluated. Seven dogs were anesthetized three times and the train-of-four (TOF) ratio was measured with acceleromyography. Vecuronium was administered at 0.1 mg/kg, 0.2 mg/kg, or 0.1 mg/kg followed by two doses of 0.05 mg/kg was administered each time. In the divided-dose treatment group, aliquots were administered on return of the first twitch (T1) of the TOF from the previous dose.
The duration of surgical block, from injection to return of T1, was longest for the divided-dose protocol, intermediate for 0.2 mg/kg single bolus, and shortest for 0.1 mg/kg (P < 0.0001). The recovery period, from return of T1 to a TOF ratio ≥0.9, was longer for 0.2 mg/kg administered as a single bolus than for the other two groups (P = 0.007). Doubling the dose of a single bolus of vecuronium extended the time of surgical block and prolonged the duration of the recovery period. However, dividing that dose into smaller aliquots extended the period of surgical block while shortening the recovery period. Hence, the spontaneous reappearance of T1 should not be used in isolation to predict the time to complete recovery of neuromuscular function.</description><identifier>ISSN: 1090-0233</identifier><identifier>EISSN: 1532-2971</identifier><identifier>DOI: 10.1016/j.tvjl.2019.04.004</identifier><identifier>PMID: 31113556</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Acceleromyography ; Anesthesia ; Anesthesia Recovery Period ; Anesthesia, General - veterinary ; Animals ; Dogs - physiology ; Dose-Response Relationship, Drug ; Electric Stimulation ; Female ; Injections, Epidural - veterinary ; Male ; Muscle, Skeletal - drug effects ; Neostigmine ; Neuromuscular ; Neuromuscular Blocking Agents - administration & dosage ; Neuromuscular Blocking Agents - pharmacology ; Neuromuscular Junction - drug effects ; Random Allocation ; Thoracic Vertebrae ; Vecuronium Bromide - administration & dosage ; Vecuronium Bromide - pharmacology</subject><ispartof>The veterinary journal (1997), 2019-06, Vol.248, p.14-17</ispartof><rights>2019 Elsevier Ltd</rights><rights>Copyright © 2019 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-e0e149c0ab6af8eb23f1ac5c91824b53105d561de2355f9be172a274aaa8e90d3</citedby><cites>FETCH-LOGICAL-c356t-e0e149c0ab6af8eb23f1ac5c91824b53105d561de2355f9be172a274aaa8e90d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31113556$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lorenzutti, A.M.</creatorcontrib><creatorcontrib>Zarazaga, M.P.</creatorcontrib><creatorcontrib>Sakai, D.M.</creatorcontrib><creatorcontrib>Nejamkin, P.</creatorcontrib><creatorcontrib>Rosetti, V.</creatorcontrib><creatorcontrib>Duran, V.</creatorcontrib><creatorcontrib>Martin-Flores, M.</creatorcontrib><title>Context-sensitive recovery of neuromuscular function from vecuronium in dogs: Effects of dose and dosing protocol</title><title>The veterinary journal (1997)</title><addtitle>Vet J</addtitle><description>•Increasing the dose of vecuronium prolonged the duration of relaxation but also slowed down the speed of spontaneous recovery.•Dividing the dose into smaller aliquots increased the duration of relaxation and shortened the recovery period.•The speed of recovery from neuromuscular block depended on the dose of the blocker and how that dose was administered.
Recovery of neuromuscular function is a gradual phenomenon whereby function progresses from absent to normal. The speed of spontaneous recovery can be used to predict the time when neuromuscular function is expected to be restored. However, the speed of recovery might be affected by the dose of the neuromuscular blocker administered, and by the dosing regimen of that dose. The effects of both factors on the speed of spontaneous recovery from vecuronium were evaluated. Seven dogs were anesthetized three times and the train-of-four (TOF) ratio was measured with acceleromyography. Vecuronium was administered at 0.1 mg/kg, 0.2 mg/kg, or 0.1 mg/kg followed by two doses of 0.05 mg/kg was administered each time. In the divided-dose treatment group, aliquots were administered on return of the first twitch (T1) of the TOF from the previous dose.
The duration of surgical block, from injection to return of T1, was longest for the divided-dose protocol, intermediate for 0.2 mg/kg single bolus, and shortest for 0.1 mg/kg (P < 0.0001). The recovery period, from return of T1 to a TOF ratio ≥0.9, was longer for 0.2 mg/kg administered as a single bolus than for the other two groups (P = 0.007). Doubling the dose of a single bolus of vecuronium extended the time of surgical block and prolonged the duration of the recovery period. However, dividing that dose into smaller aliquots extended the period of surgical block while shortening the recovery period. Hence, the spontaneous reappearance of T1 should not be used in isolation to predict the time to complete recovery of neuromuscular function.</description><subject>Acceleromyography</subject><subject>Anesthesia</subject><subject>Anesthesia Recovery Period</subject><subject>Anesthesia, General - veterinary</subject><subject>Animals</subject><subject>Dogs - physiology</subject><subject>Dose-Response Relationship, Drug</subject><subject>Electric Stimulation</subject><subject>Female</subject><subject>Injections, Epidural - veterinary</subject><subject>Male</subject><subject>Muscle, Skeletal - drug effects</subject><subject>Neostigmine</subject><subject>Neuromuscular</subject><subject>Neuromuscular Blocking Agents - administration & dosage</subject><subject>Neuromuscular Blocking Agents - pharmacology</subject><subject>Neuromuscular Junction - drug effects</subject><subject>Random Allocation</subject><subject>Thoracic Vertebrae</subject><subject>Vecuronium Bromide - administration & dosage</subject><subject>Vecuronium Bromide - pharmacology</subject><issn>1090-0233</issn><issn>1532-2971</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9kM1u1TAQhS0Eoj_wAiyQl2wSxnacGyM26KpQpEpsYG05zrjyVWK3thPRt8fRLSxZzWjmnDOaj5B3DFoGrP94ast2mlsOTLXQtQDdC3LJpOANVwf2svagoAEuxAW5yvkEAKrr-GtyIRhjQsr-kjweYyj4uzQZQ_bFb0gT2rhheqLR0YBrisua7TqbRN0abPExUFeHdENbl8GvC_WBTvE-f6I3zqEtebdOMSM1YdobH-7pQ4ol2ji_Ia-cmTO-fa7X5NfXm5_H2-bux7fvxy93jRWyLw0Csk5ZMGNv3IAjF44ZK61iA-9GKRjISfZsQl4fcWpEduCGHzpjzIAKJnFNPpxz6-HHFXPRi88W59kEjGvWnAsOgxqUrFJ-ltoUc07o9EPyi0lPmoHeUeuT3lHrHbWGTlfU1fT-OX8dF5z-Wf6yrYLPZwHWLzePSWfrMVicfEVc9BT9__L_ABkRklo</recordid><startdate>201906</startdate><enddate>201906</enddate><creator>Lorenzutti, A.M.</creator><creator>Zarazaga, M.P.</creator><creator>Sakai, D.M.</creator><creator>Nejamkin, P.</creator><creator>Rosetti, V.</creator><creator>Duran, V.</creator><creator>Martin-Flores, M.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201906</creationdate><title>Context-sensitive recovery of neuromuscular function from vecuronium in dogs: Effects of dose and dosing protocol</title><author>Lorenzutti, A.M. ; Zarazaga, M.P. ; Sakai, D.M. ; Nejamkin, P. ; Rosetti, V. ; Duran, V. ; Martin-Flores, M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-e0e149c0ab6af8eb23f1ac5c91824b53105d561de2355f9be172a274aaa8e90d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Acceleromyography</topic><topic>Anesthesia</topic><topic>Anesthesia Recovery Period</topic><topic>Anesthesia, General - veterinary</topic><topic>Animals</topic><topic>Dogs - physiology</topic><topic>Dose-Response Relationship, Drug</topic><topic>Electric Stimulation</topic><topic>Female</topic><topic>Injections, Epidural - veterinary</topic><topic>Male</topic><topic>Muscle, Skeletal - drug effects</topic><topic>Neostigmine</topic><topic>Neuromuscular</topic><topic>Neuromuscular Blocking Agents - administration & dosage</topic><topic>Neuromuscular Blocking Agents - pharmacology</topic><topic>Neuromuscular Junction - drug effects</topic><topic>Random Allocation</topic><topic>Thoracic Vertebrae</topic><topic>Vecuronium Bromide - administration & dosage</topic><topic>Vecuronium Bromide - pharmacology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lorenzutti, A.M.</creatorcontrib><creatorcontrib>Zarazaga, M.P.</creatorcontrib><creatorcontrib>Sakai, D.M.</creatorcontrib><creatorcontrib>Nejamkin, P.</creatorcontrib><creatorcontrib>Rosetti, V.</creatorcontrib><creatorcontrib>Duran, V.</creatorcontrib><creatorcontrib>Martin-Flores, M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The veterinary journal (1997)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lorenzutti, A.M.</au><au>Zarazaga, M.P.</au><au>Sakai, D.M.</au><au>Nejamkin, P.</au><au>Rosetti, V.</au><au>Duran, V.</au><au>Martin-Flores, M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Context-sensitive recovery of neuromuscular function from vecuronium in dogs: Effects of dose and dosing protocol</atitle><jtitle>The veterinary journal (1997)</jtitle><addtitle>Vet J</addtitle><date>2019-06</date><risdate>2019</risdate><volume>248</volume><spage>14</spage><epage>17</epage><pages>14-17</pages><issn>1090-0233</issn><eissn>1532-2971</eissn><abstract>•Increasing the dose of vecuronium prolonged the duration of relaxation but also slowed down the speed of spontaneous recovery.•Dividing the dose into smaller aliquots increased the duration of relaxation and shortened the recovery period.•The speed of recovery from neuromuscular block depended on the dose of the blocker and how that dose was administered.
Recovery of neuromuscular function is a gradual phenomenon whereby function progresses from absent to normal. The speed of spontaneous recovery can be used to predict the time when neuromuscular function is expected to be restored. However, the speed of recovery might be affected by the dose of the neuromuscular blocker administered, and by the dosing regimen of that dose. The effects of both factors on the speed of spontaneous recovery from vecuronium were evaluated. Seven dogs were anesthetized three times and the train-of-four (TOF) ratio was measured with acceleromyography. Vecuronium was administered at 0.1 mg/kg, 0.2 mg/kg, or 0.1 mg/kg followed by two doses of 0.05 mg/kg was administered each time. In the divided-dose treatment group, aliquots were administered on return of the first twitch (T1) of the TOF from the previous dose.
The duration of surgical block, from injection to return of T1, was longest for the divided-dose protocol, intermediate for 0.2 mg/kg single bolus, and shortest for 0.1 mg/kg (P < 0.0001). The recovery period, from return of T1 to a TOF ratio ≥0.9, was longer for 0.2 mg/kg administered as a single bolus than for the other two groups (P = 0.007). Doubling the dose of a single bolus of vecuronium extended the time of surgical block and prolonged the duration of the recovery period. However, dividing that dose into smaller aliquots extended the period of surgical block while shortening the recovery period. Hence, the spontaneous reappearance of T1 should not be used in isolation to predict the time to complete recovery of neuromuscular function.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>31113556</pmid><doi>10.1016/j.tvjl.2019.04.004</doi><tpages>4</tpages></addata></record> |
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subjects | Acceleromyography Anesthesia Anesthesia Recovery Period Anesthesia, General - veterinary Animals Dogs - physiology Dose-Response Relationship, Drug Electric Stimulation Female Injections, Epidural - veterinary Male Muscle, Skeletal - drug effects Neostigmine Neuromuscular Neuromuscular Blocking Agents - administration & dosage Neuromuscular Blocking Agents - pharmacology Neuromuscular Junction - drug effects Random Allocation Thoracic Vertebrae Vecuronium Bromide - administration & dosage Vecuronium Bromide - pharmacology |
title | Context-sensitive recovery of neuromuscular function from vecuronium in dogs: Effects of dose and dosing protocol |
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