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Anesthesiology Jul 1988Although there have been clinical reports of significant hypotension and flushing associated with the use of vecuronium, it produces minimal cardiovascular effects in...
Although there have been clinical reports of significant hypotension and flushing associated with the use of vecuronium, it produces minimal cardiovascular effects in the vast majority of patients. In addition, there is no evidence that vecuronium stimulates the release of histamine. The authors performed in vitro kinetic studies to determine the effect of vecuronium on histamine N-methyltransferase (HNMT), the primary catabolic enzyme for histamine in humans. They also examined plasma from patients who had received vecuronium (0.1 or 0.2 mg/kg) to determine whether clinically used concentrations of the drug could inhibit HNMT. It was determined that vecuronium is a strong inhibitor of HNMT; apparent Ki = 1 microM. The inhibition is competitive with respect to methyl-donor and noncompetitive with respect to histamine. Vecuronium, in doses greater than or equal to 0.1 mg/kg, may delay the metabolism of histamine by HNMT in vitro.
Topics: Histamine N-Methyltransferase; Humans; Methyltransferases; Vecuronium Bromide
PubMed: 2898903
DOI: 10.1097/00000542-198807000-00014 -
Anaesthesia Aug 1989
Topics: Adipose Tissue; Adult; Body Weight; Humans; Middle Aged; Vecuronium Bromide
PubMed: 2571309
DOI: 10.1111/j.1365-2044.1989.tb13602.x -
Journal of Photochemistry and... Nov 2014The interactions between an anesthetic, vecuronium bromide (VB) and human serum albumin (HSA) have been investigated systematically by steady-state/time-resolved...
The interactions between an anesthetic, vecuronium bromide (VB) and human serum albumin (HSA) have been investigated systematically by steady-state/time-resolved fluorescence, circular dichroism (CD), UV-vis absorption, Fourier transform infrared spectroscopy (FTIR), mass spectroscopy and differential scanning calorimetry (DSC) methods under physiological conditions. The fluorescence quenching observed is attributed to the formation of a complex between HSA and VB, and the reverse temperature effect of the fluorescence quenching has been found and discussed. Fluorescence analysis has proved that there is one classical binding site on HSA for VB with a relative weak binding constant of 1.07 × 10(4)M(-1) at 298 K. The primary binding pattern is determined by hydrogen bonding or van der Waals forces occurring in site I of HSA with ΔG°=-2.30 × 10(4)J mol(-1), ΔS°=-233 J mol(-1)K(-1) and ΔH°=-9.23 × 10(4)J mol(-1) at 298 K. VB could slightly change the secondary structure and induce unfolding of the polypeptides of protein. The DSC results provide quantitative information on the effect of VB on the stability of serum albumin. It is shown that VB can efficiently bind with HSA and be transported to the focuses needed.
Topics: Anesthetics; Biophysical Phenomena; Calorimetry; Humans; Hydrogen Bonding; Metals; Models, Molecular; Protein Binding; Protein Conformation; Serum Albumin; Spectrum Analysis; Thermodynamics; Vecuronium Bromide
PubMed: 25255425
DOI: 10.1016/j.jphotobiol.2014.08.019 -
Anaesthesia and Intensive Care Nov 1987
Topics: Adult; Anesthesia, General; Arrhythmias, Cardiac; Bradycardia; Heart Arrest; Humans; Male; Vecuronium Bromide
PubMed: 2892431
DOI: No ID Found -
Acta Anaesthesiologica Scandinavica Jan 1997We hypothesized that sequestration of a neuromuscular blocking agent could occur during surgery involving use of an extremity tourniquet and cause changes in... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
BACKGROUND
We hypothesized that sequestration of a neuromuscular blocking agent could occur during surgery involving use of an extremity tourniquet and cause changes in neuromuscular function after tourniquet release.
METHODS
Sixteen patients scheduled for total knee replacement were randomized to one of two groups. In Group I, 10 patients were administered 0.1 mg/kg of vecuronium 5 minutes prior to inflation of a pneumatic tourniquet; in Group II, 6 patients were administered 0.1 mg/kg of vecuronium after inflation of the tourniquet. The twitch (T1) and train-of-four (TOF) were analyzed before and after release of the tourniquet, as was the rate of recovery of T1 and TOF. Serial vecuronium plasma levels were drawn during the study.
RESULTS
The T1 and TOF responses and the T1 and TOF recovery rates were not significantly different between groups at tourniquet deflation. In Group I, after release of the tourniquet, T1 and TOF recovery rate decreased significantly over a 10-min period (10% +/- 3 to 4% +/- 4 and 0.12 +/- 0.06 to 0.06 +/- 0.04, mean +/- SD, respectively); in Group II, T1 and TOF recovery rate increased significantly over a 10-min period following deflation of the tourniquet (10% +/- 6 to 14% +/- 7 and 0.10 +/- 0.03 to 0.18 +/- 0.02, respectively). Changes in pharmacodynamics were temporally associated with transient but statistically significant changes in vecuronium plasma levels. Overall pharmacokinetics during the study period were comparable between groups. After administration of neostigmine 30-40 micrograms/kg i.v. all subjects in both groups showed complete TOF recovery within 15 min.
CONCLUSIONS
Sequestration of a bolus dose of vecuronium, by a pneumatic tourniquet, causes transient changes in pharmacokinetics and pharmacodynamics. These changes are of limited clinical importance and do not affect reversibility of neuromuscular block.
Topics: Hemostasis, Surgical; Humans; Leg; Middle Aged; Neuromuscular Blockade; Neuromuscular Junction; Neuromuscular Nondepolarizing Agents; Synaptic Transmission; Tourniquets; Vecuronium Bromide
PubMed: 9061114
DOI: 10.1111/j.1399-6576.1997.tb04612.x -
Annales Francaises D'anesthesie Et de... Sep 2009
Topics: Androstanols; Drug Design; Humans; Muscle Contraction; Muscle Relaxation; Neuromuscular Blockade; Neuromuscular Nondepolarizing Agents; Paralysis; Postoperative Complications; Rocuronium; Sugammadex; Vecuronium Bromide; gamma-Cyclodextrins
PubMed: 19887275
DOI: 10.1016/S0750-7658(09)72485-2 -
Anesthesia and Analgesia Aug 1990Because succinylcholine may occasionally be contraindicated for rapid-sequence induction in parturients, we studied the use of vecuronium in 21 patients having elective...
Because succinylcholine may occasionally be contraindicated for rapid-sequence induction in parturients, we studied the use of vecuronium in 21 patients having elective cesarean sections. Eleven patients (group 1) received 10 micrograms/kg vecuronium as a priming dose, followed 4-6 min later by 100 micrograms/kg. Ten patients (group 2) received 200 micrograms/kg vecuronium as a bolus. Onset, the time from the injection of vecuronium to maximal twitch suppression, and clinical duration, the time between vecuronium administration and return to 25% of the control twitch height, were recorded. Umbilical and maternal venous blood samples at delivery were analyzed for vecuronium concentrations. One-minute and 5-min Apgar scores and 1- and 24-h Neurologic and Adaptive Capacity Scores (NACS) were recorded. Individual tests of passive and active tone within the overall NACS profile were compared to evaluate further any residual vecuronium effects in the infants. Onset of neuromuscular blockade was 177 s in group 1 and 175 s in group 2. The corresponding clinical durations were 73 and 115 min. Maternal and umbilical venous vecuronium concentrations were 515 and 73 ng/mL in group 1 and 838 and 107 ng/mL in group 2. Seventy percent of neonates in group 1 had Apgar scores greater than 7 at 1 min, with 100% greater than 7 at 5 min. Corresponding values in group 2 infants were 50% and 80%. Fifty percent of group 1 infants had NACS of 35-40 at 1 h, and 70% at 24 h.(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Adult; Anesthesia, Obstetrical; Apgar Score; Cesarean Section; Female; Humans; Infant, Newborn; Intubation, Intratracheal; Pregnancy; Time Factors; Vecuronium Bromide
PubMed: 1973881
DOI: 10.1213/00000539-199008000-00012 -
Anaesthesia Mar 1990
Topics: Female; Humans; Myasthenia Gravis; Neuromuscular Junction; Vecuronium Bromide
PubMed: 1970713
DOI: 10.1111/j.1365-2044.1990.tb14707.x -
Minerva Anestesiologica May 1990Ninety patients were included in a study to assess the clinical characteristics of vecuronium bromide used in children. The myorelaxant was administered to all patients... (Clinical Trial)
Clinical Trial Comparative Study
Ninety patients were included in a study to assess the clinical characteristics of vecuronium bromide used in children. The myorelaxant was administered to all patients using different routes. The use of vecuronium at a dose approximately equal to 1ED95 was characterised by a duration of action sufficient to allow its use in short operations; on the other hand, it also produced a long induction-intubation interval and not optimal conditions in which to perform intubation. Conditions for intubation improved during induction via inhalation and there was a reduced induction-intubation interval compared to intravenous induction using the same dose of vecuronium. A further reduction in intubation time was obtained by increasing the dose from 50 to 150 micrograms/kg-1 together with an increased clinical duration of action. The "priming principle" technique also allowed intubation time to be shortened without variations in the duration of action provided a full dose of vecuronium, 100 micrograms/kg-1, was used. However, this was also associated with a notable incidence of adverse reactions. Of the various combinations examined, the most advantageous association of pre-dose and interval between doses was the association of a pre-dose of 10 micrograms/kg-1 and an interval of 4 min between doses. Lower doses countered the advantages of priming, whereas higher doses resulted in an increased number of adverse reactions without producing notable changes in the intubation time.
Topics: Adolescent; Anesthesia, General; Child; Child, Preschool; Diazepam; Dose-Response Relationship, Drug; Humans; Minor Surgical Procedures; Preanesthetic Medication; Thiopental; Vecuronium Bromide
PubMed: 1978931
DOI: No ID Found -
Anesthesia and Analgesia Apr 1996
Topics: Emergency Medicine; Humans; Neuromuscular Nondepolarizing Agents; Vecuronium Bromide
PubMed: 8615531
DOI: 10.1097/00000539-199604000-00058