The Early Reversibility of Rocuronium After Different Doses of Neostigmine
Status:
Completed
Trial end date:
2000-08-01
Target enrollment:
Participant gender:
Summary
Neuromuscular blocking agents are commonly used to facilitate endotracheal intubation.
Succinylcholine, an ultra short-acting, depolarizing neuromuscular blocking agent, is the
most commonly used agent for paralysis in this setting because of its rapid onset and short
duration of paralysis. In patients with contraindications to succinylcholine or in whom a
difficult airway is anticipated, a neuromuscular blocking agent with a pharmacodynamic
profile similar to succinylcholine would be an attractive alternative. Rocuronium, a new
intermediate-acting nondepolarizing neuromuscular blocking agent produces paralysis within 60
seconds, similar to succinylcholine, but has a duration of paralysis of approximately 20 to
30 minutes. If rocuronium-induced paralysis could be chemically reversed within 10 to 15
minutes after the administration of an intubating dose, it may be an appropriate alternative
in patients with contraindications to succinylcholine or in patients whom a difficult airway
is anticipated. Neostigmine is an anticholinesterase agent which inhibits the hydrolysis of
acetylcholine by competing with acetylcholine for attachment to acetylcholinesterase.
Inhibition of the breakdown of acetylcholine allows the neurotransmitter to be present in the
neuromuscular junction for a longer period of time, so that each molecule can bind repeatedly
with the acetylcholine receptor. The purpose of this study is to determine the dose of
neostigmine necessary for the early reversal of rocuronium-induced paralysis.
Phase:
Phase 4
Details
Lead Sponsor:
National Institutes of Health Clinical Center (CC)