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Stanley Feldman - One of the best experts on this subject based on the ideXlab platform.

  • Is rocuronium an exception to the relation between onset and offset? A comparison with Pipecuronium
    European journal of anaesthesiology, 1996
    Co-Authors: A.j. England, K. Panikkar, I. Redai, E. Haxby, S. Gopinath, Stanley Feldman
    Abstract:

    A general relation between the rate of onset and rate of recovery from non-depolarizing blockade has been demonstrated, with recovery consistently about ten times slower than onset. This observation has led to the suggestion that non-depolarizing agents share a common mechanism of action. Rocuronium, a recently introduced steroidal non-depolarizing agent, is claimed to have a very rapid onset but an intermediate duration and appears to test this hypothesis. To investigate this paradox we have calculated the rates of onset and recovery of rocuronium using the isolated human forearm and compared them with those of Pipecuronium. The mean ratio of recovery time/onset time for rocuronium was 31.3, which is significantly greater than that for Pipecuronium, 11.6 (P < 0.01). Whilst Pipecuronium conforms to the same general relation between onset and offset described previously for other non-depolarizing agents, rocuronium appears to have a disproportionately rapid rate of onset for its rate of recovery. This suggests that onset, recovery, or both onset and recovery, from rocuronium blockade occur in a different manner to that of other non-depolarizing agents.

  • Pipecuronium versus high dose vecuronium
    Anaesthesia, 1992
    Co-Authors: W. Harrop‐griffiths, M. W. Platt, N. Hirsch, Stanley Feldman
    Abstract:

    Summary The onset time and tendency to cumulation of Pipecuronium and high-dose vecuronium were compared during nitrous oxide anaesthesia supplemented with a propofol infusion. Pipecuronium 0.06 mg·kg−1 had a similar duration of action to vecuronium 0.2 mg·kg−1 (49 vs 43). Patients who received vecuronium had a shorter onset time of neuromuscular blockade (p < 0.01). Neither Pipecuronium nor vecuronium showed marked cumulation.

  • Pipecuronium versus high dose vecuronium. II. A comparison of speed of onset and cumulation during propofol anaesthesia.
    Anaesthesia, 1992
    Co-Authors: W Harrop-griffiths, N. Hirsch, M Platt, Stanley Feldman
    Abstract:

    The onset time and tendency to cumulation of Pipecuronium and high-dose vecuronium were compared during nitrous oxide anaesthesia supplemented with a propofol infusion. Pipecuronium 0.06 mg.kg-1 had a similar duration of action to vecuronium 0.2 mg.kg-1 (49 vs 43). Patients who received vecuronium had a shorter onset time of neuromuscular blockade (p less than 0.01). Neither Pipecuronium nor vecuronium showed marked cumulation.

  • Pipecuronium versus high dose vecuronium. I. A comparison of speed of onset and cumulation during isoflurane anaesthesia.
    Anaesthesia, 1992
    Co-Authors: W. Harrop‐griffiths, N Fauvel, M Plumley, Stanley Feldman
    Abstract:

    The onset time and tendency to cumulation of Pipecuronium and high-dose vecuronium were studied during nitrous oxide anaesthesia supplemented with isoflurane. Pipecuronium 0.06 mg.kg-1 had a similar duration of action to vecuronium 0.015 mg.kg-1 (42 vs 49 min). Patients who received vecuronium had a shorter onset time of neuromuscular blockade (p less than 0.01). The use of Pipecuronium was associated with marked cumulation.

Mohamed Naguib - One of the best experts on this subject based on the ideXlab platform.

  • Comparative potency of steroidal neuromuscular blocking drugs and isobolographic analysis of the interaction between rocuronium and other aminosteroids
    British journal of anaesthesia, 1995
    Co-Authors: Mohamed Naguib, Abdulhamid H. Samarkandi, Hassan S. Bakhamees, Magboul M. A. Magboul, A K El-bakry
    Abstract:

    We have determined the relative potency of rocuronium, pancuronium, Pipecuronium and vecuronium, and examined the nature of the interaction of rocuronium with the other three steroidal neuromuscular blocking drugs. We studied the dose-response relationships of each drug and their combination with rocuronium in 200 ASA I or II patients during propofol-fentanyl-nitrous oxide-oxygen anaesthesia. Neuromuscular block was recorded as the evoked thenar mechanomyographic response to single twitch stimulation of the ulnar nerve at 10-s intervals. The dose-response curves were determined by probit analysis. Isobolographic and algebraic (fractional) analyses were used to assess the combined effect of equipotent doses of rocuronium and vecuronium, Pipecuronium or pancuronium and to define the type of interaction between these drugs. The isobolograms were constructed by plotting single-drug ED50 points on the dose co-ordinates, and a combined ED50 point in the dose field. The calculated doses producing 50% depression (ED50) of the twitch height for rocuronium, pancuronium, Pipecuronium and vecuronium were 144.8 (95% confidence intervals 140.4-149.3), 32.4 (31.7-32.9), 27.1 (26.5-27.6) and 23.7 (22.7-24.8) micrograms kg-1, respectively. Corresponding doses producing 95% depression (ED95) of twitch height were, respectively, 322.1 (307.5-337.3), 58.1 (56.2-60.1), 48.7 (46.9-50.5) and 39.9 (38.4-41.4) micrograms kg-1. Based on the estimate of ED50, the relative potency was 1:4.5:5.4:6, respectively. The interaction between rocuronium and vecuronium, Pipecuronium or pancuronium was found to be additive.

  • isobolographic and dose response analysis of the interaction between Pipecuronium and vecuronium
    BJA: British Journal of Anaesthesia, 1993
    Co-Authors: Mohamed Naguib, M. Abdulatif
    Abstract:

    We have studied the neuromuscular effects of Pipecuronium, vecuronium and their combination in 130 ASA group I or II patients. Patients were anaesthetized with 0.8% halothane and 60% nitrous oxide in oxygen. Neuromuscular block was recorded as the evoked thenar mechanomyographic response to train-of-four stimulation of the ulnar nerve (2Hz at 10-s intervals). The dose-response curves were determined by probit analysis. The calculated doses producing 50% depression of the first twitch height were 15.6, 16.9 and 15.0 μg kg−1 for the Pipecuronium, vecuronium and Pipecuronium-vecuronium combination groups, respectively. Isobolo graphic and algebraic (fractional) analyses were used to assess quantitatively the combined neuromuscular effect of Pipecuronium and vecuronium and to define the type of interaction between these drugs. The interaction between Pipecuronium and vecuronium was found to be additive. (Br. J. Anaesth. 1993; 71: 556–560)

  • ISOBOLOGRAPHIC AND DOSE-RESPONSE ANALYSIS OF THE INTERACTION BETWEEN Pipecuronium AND VECURONIUM
    British journal of anaesthesia, 1993
    Co-Authors: Mohamed Naguib, M. Abdulatif
    Abstract:

    We have studied the neuromuscular effects of Pipecuronium, vecuronium and their combination in 130 ASA group I or II patients. Patients were anaesthetized with 0.8% halothane and 60% nitrous oxide in oxygen. Neuromuscular block was recorded as the evoked thenar mechanomyographic response to train-of-four stimulation of the ulnar nerve (2 Hz at 10-s intervals). The dose-response curves were determined by probit analysis. The calculated doses producing 50% depression of the first twitch height were 15.6, 16.9 and 15.0 micrograms kg-1 for the Pipecuronium, vecuronium and Pipecuronium-vecuronium combination groups, respectively. Isobolographic and algebraic (fractional) analyses were used to assess quantitatively the combined neuromuscular effect of Pipecuronium and vecuronium and to define the type of interaction between these drugs. The interaction between Pipecuronium and vecuronium was found to be additive.

  • Myasthenia gravis and Pipecuronium--report of two cases.
    Middle East journal of anaesthesiology, 1992
    Co-Authors: Mohamed Naguib, A. Sari-kouzel, Mahmoud Ashour, M. Seraj, Messahel F
    Abstract:

    The use of Pipecuronium in two patients with myasthenia gravis undergoing thymectomy is described. Neuromuscular function was monitored throughout using the train-of-four (TOF) mechanical twitch response. The cumulative dose-response to Pipecuronium was determined in both patients during nitrous oxide-oxygen-narcotic anaesthesia. Both patients were sensitive to Pipecuronium. The ED50 doses of Pipecuronium were 11.6 and 11.1 micrograms.kg-1 and the ED95 doses were 35 and 33.3 micrograms.kg-1 in patients #1 and 2 respectively. Edrophonium 1 mg.kg-1 and neostigmine 0.06 mg.kg-1 were administered to patients #1 and 2 respectively for antagonism of residual neuromuscular blockade at 25 per cent spontaneous recovery of first twitch (T1) of the TOF stimulation. As with other non-depolarizing muscle relaxants Pipecuronium in reduced dosage and with careful neuromuscular monitoring can be used to provide surgical relaxation safely in patients with controlled myasthenia gravis.

  • Pipecuronium-induced neuromuscular blockade during nitrous oxide-fentanyl, enflurane, isoflurane, and halothane anesthesia in surgical patients.
    Anesthesia and analgesia, 1992
    Co-Authors: Mohamed Naguib, Mohamed Seraj, Essam Abdulrazik
    Abstract:

    This study was designed to determine the capacity of several anesthetics to augment Pipecuronium neuromuscular blockade. The potency of Pipecuronium was determined with single-bolus administration of 20-50 micrograms/kg in 160 patients. Patients were anesthetized with N2O/O2 (60:40) supplemented with fentanyl (4-5 micrograms/kg), halothane (0.8%), isoflurane (1.2%), or enflurane (1.7%). Neuromuscular blockade was measured by an acceleration-responsive transducer (the Accelograph, Biometer International, Odense, Denmark). Responses were defined in terms of percent depression in first-twitch height and train-of-four response, and the dose-response curves were constructed after probit transformation of the responses. The dose-response curves were found to be parallel for both first twitch height and train-of-four responses. The dose-response lines for the enflurane and isoflurane groups were displaced significantly (P less than 0.01) to the left of the line for the fentanyl-N2O group. The calculated doses producing 50% depression of first twitch height were 21.9, 21.2, 18.9, and 17.8 micrograms/kg for the N2O-fentanyl, halothane, isoflurane, and enflurane groups, respectively. Corresponding calculated doses for 50% depression of train-of-four response were significantly smaller (15.5, 14.4, 13.7, 11.9 micrograms/kg, respectively). The enhancing effects of the volatile anesthetics were reflected by significant prolongation of the clinical duration of neuromuscular blockade by Pipecuronium. It is concluded that the potency of Pipecuronium is enhanced more by enflurane and isoflurane than halothane or fentanyl-N2O anesthesia.

Béla Fülesdi - One of the best experts on this subject based on the ideXlab platform.

  • Reversal of Deep Pipecuronium-Induced Neuromuscular Block With Moderate Versus Standard Dose of Sugammadex: A Randomized, Double-Blind, Noninferiority Trial.
    Anesthesia and analgesia, 2018
    Co-Authors: Edömer Tassonyi, Adrienn Pongrácz, Réka Nemes, László Asztalos, Szabolcs Lengyel, Zoltán Szabó-maák, Béla Fülesdi
    Abstract:

    Background Certain surgical interventions may require a deep neuromuscular block (NMB). Reversal of such a block before tracheal extubation is challenging. Because anticholinesterases are ineffective in deep block, sugammadex 4 mg/kg has been recommended for the reversal of rocuronium- or vecuronium-induced deep NMB. However, this recommendation requires opening 2 vials of 200 mg sugammadex, which results in an increase in drug costs. Therefore, we sought a less expensive solution for the induction and reversal of deep NMB. Although the optimal dose of sugammadex for antagonism of deep block from Pipecuronium has not been established, data pertaining to moderate block are available. Accordingly, we hypothesized that sugammadex 2 mg/kg would be a proper dose to reverse deep Pipecuronium block, enabling us to avoid cost increases. In the present study, we compared sugammadex 2 mg/kg with the standard dose of 4 mg/kg for reversal of deep block from Pipecuronium. Methods This single-center, randomized, double-blind, 2 parallel-arms, noninferiority study comprised 50 patients undergoing general anesthesia with propofol, sevoflurane, fentanyl, and Pipecuronium. Neuromuscular monitoring was performed with acceleromyography (TOF-Watch SX). Noninferiority margin was specified beforehand as an increase in reversal time of no >10% (corresponding to 1 minute for the primary outcome). When the block spontaneously recovered to posttetanic count 1, the patients randomly received sugammadex 2 or 4 mg/kg, and the time from the injection to the train-of-four (TOF) ratio of 1.0 was measured. Primary outcome was the time to achieve the normalized TOF ratio of 0.9 in a particular patient. Residual or recurrent postoperative NMB was additional end point. Results Each patient recovered to the normalized TOF ratio of 0.9. In the 2 mg/kg group, reversal time was 1.73 ± 1.03 minutes (95% confidence interval [CI], 1.33-2.13; n = 25), and in the 4 mg/kg group, reversal time was 1.42 ± 0.63 minutes (mean ± standard deviation) (95% CI, 1.17-1.67; n = 25). The mean difference in reversal times between the 2 groups was 0.31 minutes (95% CI, -0.18 to 0.8), and the upper limit of CI was below the noninferiority margin of 1 minute. Postoperative block did not occur. Conclusions The effect of sugammadex 2 mg/kg was noninferior to that of 4 mg/kg in reversing posttetanic count-1 degree Pipecuronium block. Sugammadex reversal of deep Pipecuronium block appears to be effective.

  • reversal of Pipecuronium induced moderate neuromuscular block with sugammadex in the presence of a sevoflurane anesthetic a randomized trial
    Anesthesia & Analgesia, 2015
    Co-Authors: Edömer Tassonyi, Adrienn Pongrácz, Réka Nemes, László Asztalos, Szabolcs Lengyel, Béla Fülesdi
    Abstract:

    BACKGROUND: Pipecuronium is a steroidal neuromuscular blocking agent. Sugammadex, a relaxant binding [gamma]-cyclodextrin derivative, reverses the effect of rocuronium, vecuronium, and pancuronium. We investigated whether sugammadex reverses moderate Pipecuronium-induced neuromuscular blockade (NMB) and the doses required to achieve reversal. METHODS: This single-center, randomized, double-blind, 5-group parallel-arm study comprised 50 patients undergoing general anesthesia with propofol, sevoflurane, fentanyl, and Pipecuronium. Neuromuscular monitoring was performed with acceleromyography (TOF-Watch SX(R)) according to international standards. When the NMB recovered spontaneously to train-of-four count 2, patients randomly received 1.0, 2.0, 3.0, or 4.0 mg/kg of sugammadex or placebo. Recovery time from sugammadex injection to normalized train-of-four (TOF) ratio 0.9 was the primary outcome variable. The recovery time from the sugammadex injection to final T1 was the secondary end point. Postoperative neuromuscular functions were also assessed. RESULTS: Each patient who received sugammadex recovered to a normalized TOF ratio of 0.9 within 5.0 minutes (95% lower confidence interval for the lowest dose 70.1%; for all doses 90.8%) and 79% of these patients reached a normalized TOF ratio 0.9 within 2.0 minutes (95% lower confidence interval for the lowest dose 26.7%; for all doses 63.7%). T1 recovered several minutes after the TOF ratio. No residual postoperative NMB was observed. CONCLUSIONS: Sugammadex adequately and rapidly reverses Pipecuronium-induced moderate NMB during sevoflurane anesthesia. Once the train-of-four count has spontaneously returned to 2 responses following Pipecuronium administration, a dose of 2.0 mg/kg of sugammadex is sufficient to reverse the NMB.

  • Reversal of Pipecuronium-Induced Moderate Neuromuscular Block with Sugammadex in the Presence of a Sevoflurane Anesthetic: A Randomized Trial
    Anesthesia and analgesia, 2015
    Co-Authors: Edömer Tassonyi, Adrienn Pongrácz, Réka Nemes, László Asztalos, Szabolcs Lengyel, Béla Fülesdi
    Abstract:

    Pipecuronium is a steroidal neuromuscular blocking agent. Sugammadex, a relaxant binding γ-cyclodextrin derivative, reverses the effect of rocuronium, vecuronium, and pancuronium. We investigated whether sugammadex reverses moderate Pipecuronium-induced neuromuscular blockade (NMB) and the doses required to achieve reversal. This single-center, randomized, double-blind, 5-group parallel-arm study comprised 50 patients undergoing general anesthesia with propofol, sevoflurane, fentanyl, and Pipecuronium. Neuromuscular monitoring was performed with acceleromyography (TOF-Watch SX) according to international standards. When the NMB recovered spontaneously to train-of-four count 2, patients randomly received 1.0, 2.0, 3.0, or 4.0 mg/kg of sugammadex or placebo. Recovery time from sugammadex injection to normalized train-of-four (TOF) ratio 0.9 was the primary outcome variable. The recovery time from the sugammadex injection to final T1 was the secondary end point. Postoperative neuromuscular functions were also assessed. Each patient who received sugammadex recovered to a normalized TOF ratio of 0.9 within 5.0 minutes (95% lower confidence interval for the lowest dose 70.1%; for all doses 90.8%) and 79% of these patients reached a normalized TOF ratio 0.9 within 2.0 minutes (95% lower confidence interval for the lowest dose 26.7%; for all doses 63.7%). T1 recovered several minutes after the TOF ratio. No residual postoperative NMB was observed. Sugammadex adequately and rapidly reverses Pipecuronium-induced moderate NMB during sevoflurane anesthesia. Once the train-of-four count has spontaneously returned to 2 responses following Pipecuronium administration, a dose of 2.0 mg/kg of sugammadex is sufficient to reverse the NMB.

Edömer Tassonyi - One of the best experts on this subject based on the ideXlab platform.

  • Reversal of Deep Pipecuronium-Induced Neuromuscular Block With Moderate Versus Standard Dose of Sugammadex: A Randomized, Double-Blind, Noninferiority Trial.
    Anesthesia and analgesia, 2018
    Co-Authors: Edömer Tassonyi, Adrienn Pongrácz, Réka Nemes, László Asztalos, Szabolcs Lengyel, Zoltán Szabó-maák, Béla Fülesdi
    Abstract:

    Background Certain surgical interventions may require a deep neuromuscular block (NMB). Reversal of such a block before tracheal extubation is challenging. Because anticholinesterases are ineffective in deep block, sugammadex 4 mg/kg has been recommended for the reversal of rocuronium- or vecuronium-induced deep NMB. However, this recommendation requires opening 2 vials of 200 mg sugammadex, which results in an increase in drug costs. Therefore, we sought a less expensive solution for the induction and reversal of deep NMB. Although the optimal dose of sugammadex for antagonism of deep block from Pipecuronium has not been established, data pertaining to moderate block are available. Accordingly, we hypothesized that sugammadex 2 mg/kg would be a proper dose to reverse deep Pipecuronium block, enabling us to avoid cost increases. In the present study, we compared sugammadex 2 mg/kg with the standard dose of 4 mg/kg for reversal of deep block from Pipecuronium. Methods This single-center, randomized, double-blind, 2 parallel-arms, noninferiority study comprised 50 patients undergoing general anesthesia with propofol, sevoflurane, fentanyl, and Pipecuronium. Neuromuscular monitoring was performed with acceleromyography (TOF-Watch SX). Noninferiority margin was specified beforehand as an increase in reversal time of no >10% (corresponding to 1 minute for the primary outcome). When the block spontaneously recovered to posttetanic count 1, the patients randomly received sugammadex 2 or 4 mg/kg, and the time from the injection to the train-of-four (TOF) ratio of 1.0 was measured. Primary outcome was the time to achieve the normalized TOF ratio of 0.9 in a particular patient. Residual or recurrent postoperative NMB was additional end point. Results Each patient recovered to the normalized TOF ratio of 0.9. In the 2 mg/kg group, reversal time was 1.73 ± 1.03 minutes (95% confidence interval [CI], 1.33-2.13; n = 25), and in the 4 mg/kg group, reversal time was 1.42 ± 0.63 minutes (mean ± standard deviation) (95% CI, 1.17-1.67; n = 25). The mean difference in reversal times between the 2 groups was 0.31 minutes (95% CI, -0.18 to 0.8), and the upper limit of CI was below the noninferiority margin of 1 minute. Postoperative block did not occur. Conclusions The effect of sugammadex 2 mg/kg was noninferior to that of 4 mg/kg in reversing posttetanic count-1 degree Pipecuronium block. Sugammadex reversal of deep Pipecuronium block appears to be effective.

  • reversal of Pipecuronium induced moderate neuromuscular block with sugammadex in the presence of a sevoflurane anesthetic a randomized trial
    Anesthesia & Analgesia, 2015
    Co-Authors: Edömer Tassonyi, Adrienn Pongrácz, Réka Nemes, László Asztalos, Szabolcs Lengyel, Béla Fülesdi
    Abstract:

    BACKGROUND: Pipecuronium is a steroidal neuromuscular blocking agent. Sugammadex, a relaxant binding [gamma]-cyclodextrin derivative, reverses the effect of rocuronium, vecuronium, and pancuronium. We investigated whether sugammadex reverses moderate Pipecuronium-induced neuromuscular blockade (NMB) and the doses required to achieve reversal. METHODS: This single-center, randomized, double-blind, 5-group parallel-arm study comprised 50 patients undergoing general anesthesia with propofol, sevoflurane, fentanyl, and Pipecuronium. Neuromuscular monitoring was performed with acceleromyography (TOF-Watch SX(R)) according to international standards. When the NMB recovered spontaneously to train-of-four count 2, patients randomly received 1.0, 2.0, 3.0, or 4.0 mg/kg of sugammadex or placebo. Recovery time from sugammadex injection to normalized train-of-four (TOF) ratio 0.9 was the primary outcome variable. The recovery time from the sugammadex injection to final T1 was the secondary end point. Postoperative neuromuscular functions were also assessed. RESULTS: Each patient who received sugammadex recovered to a normalized TOF ratio of 0.9 within 5.0 minutes (95% lower confidence interval for the lowest dose 70.1%; for all doses 90.8%) and 79% of these patients reached a normalized TOF ratio 0.9 within 2.0 minutes (95% lower confidence interval for the lowest dose 26.7%; for all doses 63.7%). T1 recovered several minutes after the TOF ratio. No residual postoperative NMB was observed. CONCLUSIONS: Sugammadex adequately and rapidly reverses Pipecuronium-induced moderate NMB during sevoflurane anesthesia. Once the train-of-four count has spontaneously returned to 2 responses following Pipecuronium administration, a dose of 2.0 mg/kg of sugammadex is sufficient to reverse the NMB.

  • Reversal of Pipecuronium-Induced Moderate Neuromuscular Block with Sugammadex in the Presence of a Sevoflurane Anesthetic: A Randomized Trial
    Anesthesia and analgesia, 2015
    Co-Authors: Edömer Tassonyi, Adrienn Pongrácz, Réka Nemes, László Asztalos, Szabolcs Lengyel, Béla Fülesdi
    Abstract:

    Pipecuronium is a steroidal neuromuscular blocking agent. Sugammadex, a relaxant binding γ-cyclodextrin derivative, reverses the effect of rocuronium, vecuronium, and pancuronium. We investigated whether sugammadex reverses moderate Pipecuronium-induced neuromuscular blockade (NMB) and the doses required to achieve reversal. This single-center, randomized, double-blind, 5-group parallel-arm study comprised 50 patients undergoing general anesthesia with propofol, sevoflurane, fentanyl, and Pipecuronium. Neuromuscular monitoring was performed with acceleromyography (TOF-Watch SX) according to international standards. When the NMB recovered spontaneously to train-of-four count 2, patients randomly received 1.0, 2.0, 3.0, or 4.0 mg/kg of sugammadex or placebo. Recovery time from sugammadex injection to normalized train-of-four (TOF) ratio 0.9 was the primary outcome variable. The recovery time from the sugammadex injection to final T1 was the secondary end point. Postoperative neuromuscular functions were also assessed. Each patient who received sugammadex recovered to a normalized TOF ratio of 0.9 within 5.0 minutes (95% lower confidence interval for the lowest dose 70.1%; for all doses 90.8%) and 79% of these patients reached a normalized TOF ratio 0.9 within 2.0 minutes (95% lower confidence interval for the lowest dose 26.7%; for all doses 63.7%). T1 recovered several minutes after the TOF ratio. No residual postoperative NMB was observed. Sugammadex adequately and rapidly reverses Pipecuronium-induced moderate NMB during sevoflurane anesthesia. Once the train-of-four count has spontaneously returned to 2 responses following Pipecuronium administration, a dose of 2.0 mg/kg of sugammadex is sufficient to reverse the NMB.

  • Pharmacokinetics of Pipecuronium in infants, children and adults
    European Journal of Drug Metabolism and Pharmacokinetics, 1995
    Co-Authors: Edömer Tassonyi, J-f. Pittet, C. N. Schopfer, J-c. Rouge, G. Gemperle, O. H. G. Wilder-smith, D. R. Morel
    Abstract:

    In order to explain the reported shorter clinical duration of action of cumulative ED_95 of Pipecuronium in infants as compared to children or adults, the pharmacokinetic profiles of Pipecuronium were compared in infants (n=6; mean age 6.8 months; mean weight 7.3 kg) in children (n=6; mean age 4.6 years; mean weight 19.2 kg) and in adults (n=7; mean age 42 years; mean weight 58.2 kg). Equipotent doses (2 × ED_95) of Pipecuronium were injected i.v. as single bolus and arterial blood was sampled for 4–5 h. Pipecuronium was quantified by complex formation with [^125I]-labelled rose bengal. Pharmacokinetic parameters were calculated using a two-compartment open model. The median for the distribution half-life of Pipecuronium was 2.54 min (interquartile range: 1.0–2.5 min) in infants and 2.04 min (0.26–2.04 min) in children; both were significantly shorter than in adults (5.75 [3.7–9.7] min). The plasma clearance of Pipecuronium was significantly decreased in infants (1.50 [0.6–1.5] ml.min^−1.kg^−1; P

  • Pharmacokinetics of Pipecuronium in infants, children and adults
    European journal of drug metabolism and pharmacokinetics, 1995
    Co-Authors: Edömer Tassonyi, G. Gemperle, Jean-francois Pittet, C. Schopfer, O. H. G. Wilder‐smith, Denis R. Morel
    Abstract:

    In order to explain the reported shorter clinical duration of action of cumulative ED95 of Pipecuronium in infants as compared to children or adults, the pharmacokinetic profiles of Pipecuronium were compared in infants (n=6; mean age 6.8 months; mean weight 7.3 kg) in children (n=6; mean age 4.6 years; mean weight 19.2 kg) and in adults (n=7; mean age 42 years; mean weight 58.2 kg).

W. Harrop‐griffiths - One of the best experts on this subject based on the ideXlab platform.