Effect of priming in shortening onset of pipecuronium, a new nondepolarizing neuromuscular blocker.
OBJECTIVE
One of the most important neuromuscular blockers property is short onset, allowing early tracheal intubation. Low nondepolarizing blocker dose before the full dose is known to decrease the onset of most neuromuscular blockers. Pipecuronium bromide is a long-lasting aminosteroid with major cardiovascular stability, however, with late onset. This study aimed at evaluating pipecuronium priming effect in adult patients submitted to elective surgeries under general anesthesia.


METHODS
Participated in this study 33 adult patients of both genders, aged 20 to 65 years, physical status ASA I or II, to be submitted to elective surgeries under general anesthesia. Exclusion criteria were patients with kidney or liver failure, neuromuscular diseases, in concurrent use of drugs influencing pipecuronium pharmacokinetics, and patients with family history of malignant hyperthermia. Patients were divided in 2 groups: Group 1 = priming with 0.01 mg kg(-1) and 3 minutes later the remaining 0.07 mg kg(-1) (total 0.08 mg kg(-1)); Group 2 = no priming dose (group control). Neuromuscular relaxation was controlled by acceleromyography (TOF-Guard device) and laryngoscopy was accomplished when T1 < 10%. T test for independent samples was used for statistical analysis and Shapiro Wilks was used to test normality.


RESULTS
Groups were homogeneous. Time for T1 < 10% was 161.4 +/- 13.7 seconds for Group 1 and 217.8 +/- 23.4 seconds for Group 2, with p < 0.001 and statistically significant differences between groups.


CONCLUSIONS
Our results have shown statistically significant differences between groups with and without priming, indicating that pipecuronium also has its onset decreased, similarly to other known neuromuscular blockers.
Canga
José Carlos
JC
CET Integrado de Anestesiologia, Faculdade de Medicina ABC, Santo André, SP, Brazil.
Lehn
Carlos Neutzling
CN
Tonelli
Deoclécio
D
Sacco
Paula de Camargo Neves
Pde C
Beltrão
Danielle
D
Kirsch
Marcelo
M
Serralheiro
Fernando César
FC
Cimerman
Gustavo
G