title: Onset and duration of intravenous and intraosseous rocuronium in swine.
abstract: BACKGROUND
  The intraosseous (IO) route has become a popular method to gain access to the peripheral circulation in emergency situations. Despite little supporting data, it is generally believed that IO absorption is immediate and equivalent to the intravenous (IV) route. It is important to determine if rocuronium can effectively be administered by the IO route. The aim of the study was to determine and compare the onset and duration of rocuronium when administered via the IO and IV routes in a normovolemic pig model.
  
  
  METHODS
  We recorded electromyographic (EMG) data following tibial IO and peripheral IV administration of rocuronium (1.2 mg/kg) in 10 swine weighing between 56 and 71 Kg. We transformed data were transformed to percent of baseline, determined onset and recovery characteristics.
  
  
  RESULTS
  The onset EMG-time profiles for IO and IV administration were very similar: tibial IO compared to IV administration did not statistically alter the onset of paralysis. The IO group took statistically longer than the IV group to return to 50 (p=0.042), 75 (p=0.034) and 95 (p=0.036) percent of baseline activity.
  
  
  CONCLUSIONS
  The duration of effect is statistically longer after IO administration but is more of an academic interest than a clinical concern. The results of this study suggest that rocuronium can effectively be administered via the IO route without the need for dose adjustments.
authors.affiliation: Department of Anesthesia & Operative Services, Madigan Army Medical Center, Tacoma, Washington.
authors.forename: Michael
authors.initials: M
authors.lastname: Loughren
authors.affiliation: Department of Anesthesia & Operative Services, Madigan Army Medical Center, Tacoma, Washington.
authors.forename: Sarah
authors.initials: S
authors.lastname: Banks
authors.affiliation: Department of Anesthesia & Operative Services, Madigan Army Medical Center, Tacoma, Washington.
authors.forename: Carleo
authors.initials: C
authors.lastname: Naluan
authors.affiliation: Department of Anesthesia & Operative Services, Madigan Army Medical Center, Tacoma, Washington.
authors.forename: Paul
authors.initials: P
authors.lastname: Portenlanger
authors.affiliation: Department of Anesthesia & Operative Services, Madigan Army Medical Center, Tacoma, Washington.
authors.forename: Arthur
authors.initials: A
authors.lastname: Wendorf
authors.affiliation: Department of Anesthesia & Operative Services, Madigan Army Medical Center, Tacoma, Washington.
authors.forename: Don
authors.initials: D
authors.lastname: Johnson
mesh_terms: D000732:Androstanols / Q000008:administration & dosage* / Q000494:pharmacology; D000818:Animals; D004576:Electromyography / Q000187:drug effects; D017148:Infusions, Intraosseous; D007262:Infusions, Intravenous; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage* / Q000494:pharmacology; D000077123:Rocuronium; D013552:Swine / Q000378:metabolism
chemical_list: D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D000077123:Rocuronium