Bom, A.H.

Sugammadex reverses neuromuscular block induced by 3-desacetyl-vecuronium, an active metabolite of vecuronium, in the anaesthetised rhesus monkey (Article)

2011-04-01T00:00:00Z

Background and objective 3-Desacetyl-vecuronium is an active metabolite of the neuromuscular blocking agent (NMBA) vecuronium, which might lead to residual paralysis after prolonged administration of vecuronium in critically ill patients with renal failure. This study investigated the ability of sugammadex to reverse 3-desacetyl-vecuronium-induced neuromuscular block (NMB) in the anaesthetised rhesus monkey. Methods Experiments were performed in anaesthetised female rhesus monkeys. After bolus intravenous injection of vecuronium (n=8) or 3-desacetyl-vecuronium (n=8) 10mgkg-1(ED90), a continuous infusion of the same NMBA was started to maintain the first twitch of the train-of-four (TOF) at 10% of baseline value. The infusion was stopped and NMB recovered spontaneously. The procedure was repeated, but immediately after stopping the infusion, an intravenous bolus dose of sugammadex 0.5 or 1.0mgkg-1was given. For each NMBA, four placebo experiments were performed, in which the second recovery from NMB was also spontaneous. For all experiments, time to recovery of the TOF ratio to 90% was retrieved. Results After administration of sugammadex for reversal of 3-desacetyl-vecuronium-induced NMB, recovery was significantly faster than spontaneous recovery. Mean time to recovery of TOF to 90% was 3.2 min (sugammadex 0.5mgkg-1) and 2.6 min (1.0mg kg-1), compared to spontaneous recovery (17.6 min). For vecuronium-induced NMB, mean time to recovery of TOF to 90% was 17.1 min (0.5mgkg-1) and 4.6 min (1.0mgkg-1), compared to spontaneous recovery (23.4 min). Conclusion Sugammadex rapidly and effectively reversed 3-desacetyl-vecuronium-induced NMB in the rhesus monkey, at a lower dose than that needed to reverse vecuronium-induced NMB.

Reversal of rocuronium-induced neuromuscular block by sugammadex is independent of renal perfusion in anesthetized cats (Article)

2011-04-01T00:00:00Z

Purpose Sugammadex is a selective relaxant binding agent designed to encapsulate the aminosteroidal neuromuscular blocking agent rocuronium, thereby reversing its effect. Both sugammadex and the sugammadex-rocuronium complex are eliminated by the kidneys. This study investigated the effect of sugammadex on recovery of rocuronium-induced neuromuscular block in cats with clamped renal pedicles, as a model for acute renal failure. Methods Twelve male cats were divided into two groups and anesthetized with medetomidine, ketamine, and alphachloralose. The cats were intubated and ventilated with a mixture of oxygen and air. Neuromuscular monitoring was performed by single twitch monitoring. Rocuronium 0.5 mg/kg i.v. was administered. After spontaneous recovery from neuromuscular block, both renal pedicles were ligated. A second dose of rocuronium 0.5 mg/kg i.v. was given. One minute after disappearance of the twitches, in Group 1 placebo (0.9% saline) and in Group 2 sugammadex 5.0 mg/kg i.v. was administered. Onset time, duration of neuromuscular block, and time to recovery to 25, 50, 75, and 90% were determined. Results After renal pedicle ligation, sugammadex reversed rocuronium-induced neuromuscular block significantly faster than spontaneous recovery. Mean time (SEM) to 90% recovery of the twitch response was 4.7 (0.25) min (Group 2) versus 31.1 (5.0) min (Group 1) (p<0.0001). No signs of recurrence of neuromuscular block were observed for 90 min after complete twitch restoration. Sugammadex caused no significant cardiovascular effects. Conclusion Sugammadex rapidly and effectively reversed rocuronium-induced neuromuscular block in anesthetized cats, even when both renal pedicles were ligated and renal elimination of the drugs was no longer possible.

Regional wall motion from radiopaque markers after intravenous and intracoronary injections of nifedipine (Article)

1981-01-01T00:00:00Z

Echocardiologie de contraste en deux dimensions et en temps réel. 2 Applications cliniques (Article)

1978-01-01T00:00:00Z

The anatomical and functional abnormalities which are the basis of septal defects and valvular incompetence can be visualised directly by two-dimensional contrast echocardiology. Although right-left shunts at atrial or ventricular level can easily be discovered and visualised after injection peripherally, the same is not true of left-right ventricular shunts; these are not detectable. As for left-right shunts (as demonstrated by oxymetry) at the atrial level, these are in a separate category; the passage of ultrasonic contrast medium from right to left is inconstant. This technique also allows the study of abnormal blood flow: tricuspid incompetence, turbulence caused by prosthetic valves, etc.