Effects of nicardipine on the onset time and intubation conditions of rocuronium-induced neuromuscular blockade.
OBJECTIVE
The objective of this study was to identify the effects of nicardipine on neuromuscular blockade of rocuronium, such as the onset time and intubation conditions, using a nicardipine dose that attenuates cardiovascular responses during endotracheal intubation.


METHODS
Randomized, double-blinded, placebo-controlled clinical comparison was used as the design of this study


METHODS
The study was conducted at the operating room of a university hospital.


METHODS
Participants of this study comprise 78 American Society of Anesthesiologists physical status 1 and 2 patients, aged 18 to 60 years who were undergoing elective surgery under general anesthesia.


METHODS
The nicardipine group was given an intravenous bolus of 20 μg/kg nicardipine before tracheal intubation: the control group was given an intravenous bolus of a comparable volume of normal saline before tracheal intubation.


METHODS
Using a TOF-Watch SX monitor, the time from the end of the injection of rocuronium to maximum depression of T1 (onset time) was measured. Intubation was performed 1 minute after rocuronium administration, and the status of the intubation conditions was assessed. The mean blood pressure and heart rate were each measured after endotracheal intubation. Rate pressure product values were also calculated.


RESULTS
Intubation conditions were clinically acceptable in 37 (94.9%) of 39 patients in group N compared with 29 (74.4%) of 39 in group C (P < .05). The onset time of rocuronium was significantly faster in group N than in group C (P < .05). The mean blood pressure was significantly lower in group N than in group C (P < .05). The heart rate was significantly higher in group N than in group C (P < .05). Rate pressure product values showed no significant difference between the two groups (P > .05).


CONCLUSIONS
Pretreatment with 20 μg/kg nicardipine improves intubation conditions, shortens the onset time of rocuronium, and attenuates cardiovascular responses to tracheal intubation.
Department of Anesthesiology and Pain Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
Sun-Yeul
SY
Lee
Department of Anesthesiology and Pain Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
Yoon-Hee
YH
Kim
Department of Anesthesiology and Pain Medicine, Chungnam National University School of Medicine, Daejeon, Korea. Electronic address: annn8432@gmail.com.
Young-Kwon
YK
Ko
Department of Anesthesiology and Pain Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
Sang-Il
SI
Park
Department of Anesthesiology and Pain Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
Jung-Un
JU
Lee
Department of Anesthesiology and Pain Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
Woo-Suk
WS
Chung
Department of Anesthesiology and Pain Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
Chae-Seong
CS
Lim
D000293:Adolescent; D000328:Adult; D000732:Androstanols / Q000494:pharmacology*; D002121:Calcium Channel Blockers / Q000494:pharmacology; D004311:Double-Blind Method; D004357:Drug Synergism; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007442:Intubation, Intratracheal; D008297:Male; D008875:Middle Aged; D019148:Neuromuscular Blockade / Q000379:methods*; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology; D009529:Nicardipine / Q000494:pharmacology*; D000077123:Rocuronium; D013997:Time Factors; D055815:Young Adult
D000732:Androstanols; D002121:Calcium Channel Blockers; D003473:Neuromuscular Nondepolarizing Agents; D009529:Nicardipine; D000077123:Rocuronium
Intubation; Neuromuscular blockade; Nicardipine; Rocuronium