title: The neuromuscular blocking and cardiovascular effects of doxacurium chloride in patients receiving nitrous oxide narcotic anesthesia.
abstract: The purpose of this study was to evaluate neuromuscular and cardiovascular effects of doxacurium chloride, a new long-acting neuromuscular blocking agent, during a stable state of nitrous oxide and narcotic anesthesia. Ninety-three ASA physical status I or II patients were studied after informed written consent had been obtained. Eighty-one patients (group A) received doxacurium. The 81 patients were divided into nine subgroups according to the dose of doxacurium administered (0.01-0.06 mg.kg-1). Patients in a control group (group B) (n = 12) received pancuronium. To assess neuromuscular responses, a force displacement transducer recorded the twitch response of the adductor pollicis muscle following ulnar nerve stimulation. The ED50 and ED95 for doxacurium were estimated to be 0.013 mg.kg-1 and 0.023 mg.kg-1, respectively. The time to maximum twitch suppression following a dose of 1.0 (ED95) and 1.7 (ED95) was 10.3 +/- 1.3 min and 7.6 +/- 0.8 min, respectively. After an ED95 dose of doxacurium the time to spontaneous recovery to 95% of control twitch height was 73.7 +/- 8.7 min. With larger doses of doxacurium, 0.04 mg.kg-1 (1.7 X ED95) and 0.05 mg.kg-1 (2.2 X ED95), the time to spontaneous recovery to 95% of control twitch height was 125.8 +/- 24.8 and 204.0 +/- 21.2 minutes, respectively. When 25% twitch height recovery or more was present the reversal of doxacurium induced neuromuscular blockade was prompt.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Anesthesia, University of Iowa Hospitals and Clinics, Iowa City.
authors.forename: D J
authors.initials: DJ
authors.lastname: Murray
authors.forename: M P
authors.initials: MP
authors.lastname: Mehta
authors.forename: W W
authors.initials: WW
authors.lastname: Choi
authors.forename: R B
authors.initials: RB
authors.lastname: Forbes
authors.forename: M D
authors.initials: MD
authors.lastname: Sokoll
authors.forename: S D
authors.initials: SD
authors.lastname: Gergis
authors.forename: G D
authors.initials: GD
authors.lastname: Rudd
authors.forename: M M
authors.initials: MM
authors.lastname: Abou-Donia
mesh_terms: D000293:Adolescent; D000328:Adult; D000758:Anesthesia; D001794:Blood Pressure / Q000187:drug effects; D002319:Cardiovascular System / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007546:Isoquinolines / Q000494:pharmacology*; D008875:Middle Aged; D009294:Narcotics; D009466:Neuromuscular Blocking Agents / Q000494:pharmacology; D009609:Nitrous Oxide; D010197:Pancuronium / Q000494:pharmacology
chemical_list: D007546:Isoquinolines; D009294:Narcotics; D009466:Neuromuscular Blocking Agents; D010197:Pancuronium; D009609:Nitrous Oxide; C049429:doxacurium