Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We studied the suitability of pipecuronium for maintenance of neuromuscular block during 20 elective Caesarean sections under light general anaesthesia with a rapid-sequence technique facilitated by i.v. suxamethonium 0.6-0.8 mg kg-1. An initial dose of 0.035 mg kg-1 or 0.05 mg kg-1 of pipecuronium provided satisfactory relaxation of similar speed of onset (3.1 +/- 0.3 vs 3.8 +/- 0.6 min, p = 0.25); however the higher dose had a significantly longer duration of action than the lower dose (from injection to recovery to 20% of baseline 13.1 +/- 1.8 vs 39.3 +/- 6.9 min, p < 0.05). A spontaneous recovery of the T1 twitch of the train-of-four to 25% of baseline (residual block 75%) assured rapid antagonism of the residual block with either edrophonium 0.5 mg kg-1 or neostigmine 0.04 mg kg-1. A residual block greater than 80% depression of T1 markedly prolonged the time taken to achieve a satisfactory reversal. Pipecuronium had negligible cardiovascular effects and placental transfer. It had no observable effect on the newborn. In spite of some advantages, we conclude that pipecuronium is a suitable alternative during Caesarean section only when used judiciously in small doses for maintenance of neuromuscular block and recommend that the initial dose be no greater than 0.035 mg kg-1.
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PMID:Neuromuscular blocking effect and placental gradient of pipecuronium bromide in elective caesarean section. 133 47

Pipecuronium, a new muscle relaxant, was examined in surgical patients in a multi-center cooperative study. Neuromuscular blocking action, circulatory effect and side effects of pipecuronium were investigated in comparison with those of pancuronium bromide. Mechanical twitch responses of adductor pollicis muscle evoked by supramaximal stimulation of the ulnar nerve every ten seconds were recorded. The following results were obtained. 1. Approximately 100% twitch depression was obtained after the administration of pipecuronium 0.04 mg.kg-1. 2. Enflurane and halothane did not influence the onset time and recovery time. But enflurane showed more prolonging effect on the duration of pipecuronium induced block than halothane. 3. No clinically significant changes in heart rate and blood pressure were observed. It was concluded that the minimum of 0.04 mg.kg-1 of pipecuronium is necessary for an initial dose and the maintenance dose of pipecuronium can be reduced under enflurane anesthesia.
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PMID:[Evaluation of pipecuronium bromide during halothane or enflurane anesthesia--a comparison with pancuronium regarding the optimal dose and the effect of volatile anesthetics on neuromuscular blockade]. 839 89

Pipecuronium effective doses 50,90,95 (ED50, ED90, ED95) have been obtained with the cumulative dosage method studying the influences of two different anesthetic techniques (TIVA vs isoflurane), of the patients age, of two different monitoring techniques, force transduction vs accelerometry, both evaluated by T1/TC ratio, ratio between Ist muscular response following the muscle relaxant and the values obtained before its injection, and TOFR, ratio between 4th and Ist response of every train. 33 patients, 55 years average age, 66 kgs average weight, ASA 1&2, scheduled for elective operations were anesthetized with propofol-fentanyl-N2O; tracheas were intubate under topical analgesia; maintenance of anesthesia included propofol and fentanyl or isoflurane 1 MAC. Neuromuscular monitoring included the simultaneous measurement of force of thumb adduction (FT 10 Grass) and its acceleration (Tofguard); neuromuscular blockade was evaluated by T1/TC and TOFR. Pipecuronium was administered in small decreasing boluses until 95% of T1/TC depression. Under force monitoring, ED50, ED90, ED95 values were 19, 28, 33 micrograms/kg respectively with T1/TC, being slightly lower with TOF stimulation (15, 24, 26 micrograms/kg); ED's were not influenced by anesthesia and were inversely related to age. Under accelerometry, EDs were always lower (16,27 e 27 micrograms/kg) under T1/TC, while with tof their values were similar to those derived from force measurements. ED's values obtained with T1/TC, either with force than accelerometry, while accelerometry was more sensitive than force for all ED's. EDs values, both under T1/TC than TOF, either with force transduction than accelerometry, resulted highly correlated each other, indicating a substantial agreement between the two mechanical methods of monitoring. It is concluded that the new instrument Tofguard offers the same reliability than force transduction, with the advantages of being smaller, portable and able to calculate directly the depth of neuromuscular blockade.
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PMID:[A new instrument for neuromuscular transmission monitoring: the accelerometer Tofguard. Comparative study of isometric force transduction in the assessment of pipecuronium dose-response relationship]. 867 38