Comparison of The Effects of Rocuronium Bromide And Cis-Atracurium Besylate on Intubating Conditions And Haemodynamic Response
DOI:
https://doi.org/10.61841/6vh6t881Keywords:
Intubation, haemodynamic, response, pressor respons, cisatracurium, rocuroniumAbstract
Background/rationale: Safe and rapid endotracheal intubation is of cardinal importance in general anaesthesia. The ease of endotracheal intubation depends on a multitude of factors like degree of muscle relaxation, depth of anaesthesia and skill of the intubating anaesthesiologist. The haemodynamic effects like tachycardia, hypertension[1] is initiated within 5 s of laryngoscopy, peaks in 1–2 min and returns to normal levels by 5 min. It can incite harmful effects such as myocardial ischaemia, ventricular dysrrhythmias, ventricular failure and pulmonary oedema which is attenuated by the use of drugs like Lignocaine, Dexmedetomidine. [2,3,4,5,6]. Cisatracurium besylate is a bisbenzyl- tetrahydro-isoquinoliniumn, in the category of non-depolarizing neuromuscular intermediate in its onset and duration of action. Cisatracurium degrades spontaneously at physiological pH via Hofmann elimination to yield an active laudanosine and the quaternary monoacrylate . [7]The recommended maintenance dose of Cis-atracurium is 0.03 mgkg–1 ,following 40-50 min after the intubating bolus dose of 0.15 mgkg–1 . Rocuronium bromide is structurally a 2 morpholino 3-disacetyl 16 N-allyl pyrrolidino derivative of thenon depolarizing muscle relaxant, vecuronium. The recommended intubating dose in general anaesthesia is 0.6mg per kg body weight, after which clinically acceptable intubation conditions are established within 60 seconds in nearly all patients. The recommended maintenance dose is 0.15mg per kg body weight but in the case of use of inhalational anaesthesia for a long duration, this should be reduced to 0.075-0.1mg per kg body weight. Neostigmine or Suggamadex can be used as the reversal agent. Objectives: The objectives are to compare the intubating conditions of rocuronium and cis- atracurium and haemodynamic stability of these agents during intubation. Any side effects are noted
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[1] Gaikwad, Kapila B., Nitin G. Joshi, and Sohan P. Selkar. “Study of Nitrosative Stress in `Pregnancy Induced Hypertension’.” JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH 11, no. 3 (March 2017): BC6–
8. https://doi.org/10.7860/JCDR/2017/23960.9396
[2] Singh, Roona, and Amol Singam. “Comparative Evaluation of Dexmedetomedine versus Clonidine as an Adjuvant in Supraclavicular Brachial Plexus Block.” JOURNAL OF KRISHNA INSTITUTE OF MEDICAL SCIENCES UNIVERSITY 8, no. 3 (September 2019): 53–65
[3] Sebastian B, Talikoti AT, Krishnamurthy D. Attenuation of haemodynamic responses to laryngoscopy and endotracheal intubation with intravenous dexmedetomidine: A comparison between two doses. Indian J Anaesth. 2017;61(1):48-54.
[4] Kumar S, Mishra MN, Mishra LS, Bathla S. Comparative study of the efficacy of I.V. esmolol, diltiazem and magnesium sulphate in attenuating haemodynamic response to laryngoscopy and tracheal intubation. Indian J Anaesth. 2003;47:41–4.
[5] Gulabani M, Gurha P, Dass P, Kulshreshtha N. Comparative analysis of efficacy of lignocaine 1.5 mg/kg and two different doses of dexmedetomidine (0.5 μg/kg and 1 μg/kg) in attenuating the hemodynamic pressure response to laryngoscopy and intubation. Anesth Essays Res. 2015;9:5–14.
[6] Tendulkar, Malvika Prasad, and Sanjot Sudhir Ninave. “Prospective Comparison of Pressor and Airway Responses to IV Esmolol and IV Dexmedetomidine during Emergence from General Anaesthesia and Extubation.” JOURNAL OF KRISHNA INSTITUTE OF MEDICAL SCIENCES UNIVERSITY 6, no. 1 (March 2017): 49–56.
[7] Neeraja Bharti et al. Rocuronium, time course of action and intubating conditions – A comparison with atracurium and vecuronium. Indian J Anaesth 2001; 45(5): 363-369.
[8] Panchbhai, Aarati. “Effect of Oral Submucous Fibrosis on Jaw Dimensions.” TURKISH JOURNAL OF ORTHODONTICS 32, no. 2 (June 2019): 105–9.
[9] Bhola, Nitin, Anendd Jadhav, Atul Kala, Rahul Deshmukh, Umesh Bhutekar, and G. S. V. Prasad. “Anterior Submandibular Approach for Transmylohyoid Endotracheal Intubation: A Reappraisal with Prospective Study in 206 Cases of Craniomaxillofacial Fractures.” CRANIOMAXILLOFACIAL TRAUMA & RECONSTRUCTION 10, no. 4 (December 2017): 255–62. https://doi.org/10.1055/s-0037-1607063.
[10] Gadbail, Amol Ramchandra, Minal Chaudhary, Madhuri Gawande, Alka Hande, Sachin Sarode, Satyajit Ashok Tekade, Sheetal Korde, et al. “Oral Squamous Cell Carcinoma in the Background of Oral Submucous Fibrosis Is a Distinct Clinicopathological Entity with Better Prognosis.” JOURNAL OF ORAL PATHOLOGY & MEDICINE 46, no. 6 (July 2017): 448–53. https://doi.org/10.1111/jop.12553
[11] Karia, Himija, Sunita Shrivastav, and Ashok Kumar Karia. “Three-Dimensional Evaluation of the Airway Spaces in Patients with and without Cleft Lip and Palate: A Digital Volume Tomographic Study.” AMERICAN JOURNAL OF ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS 152, no. 3
(September 2017): 371–81. https://doi.org/10.1016/j.ajodo.2016.12.026.
[12] Palan, Astha, and N. K. Agrawal. “Control of Intraoperative Shivering Under Spinal Anaesthesia- A Prospective Randomized Comparative Study of Butorphanol with Tramadol.” JOURNAL OF KRISHNA INSTITUTE OF MEDICAL SCIENCES UNIVERSITY 6, no. 1 (March 2017): 57–65.
[13] Reddy, K. Varun, Anendd Jadhav, Nitin Bhola, Apoorva Mishra, and Prachet Dakshinkar. “Is 0.75% Ropivacaine More Efficacious than 2% Lignocaine with 1:80,000 Epinephrine for IANB in Surgical Extraction of Impacted Lower Third Molar?” ORAL AND MAXILLOFACIAL SURGERY-HEIDELBERG 23, no. 2 (June 2019): 225–31.
[14] Rajan, R., S.N. Gosavi, V. Dhakate, and S. Ninave. “A Comparative Study of Equipotent Doses of Intrathecal Clonidine and Dexmedetomidine on Characteristics of Bupivacaine Spinal Anesthesia.” Journal of Datta Meghe Institute of Medical Sciences University 13, no. 1 (2018): 4–8. https://doi.org/10.4103/jdmimsu.jdmimsu.
[15] Rathi, N.V., A.A. Khatri, A.G. Agrawal, M. Sudhindra Baliga, N.R. Thosar, and S.G. Deolia. “Anesthetic Efficacy of Buccal Infiltration Articaine versus Lidocaine for Extraction of Primary Molar Teeth.” Anesthesia Progress 66, no. 1 (2019): 3–7. https://doi.org/10.2344/anpr-65-04-02.
[16] Palan, A., and N.K. Agrawal. “Control of Intraoperative Shivering under Spinal Anaesthesia- A Prospective Randomized Comparative Study of Butorphanol with Tramadol.” Journal of Krishna Institute of Medical Sciences University 6, no. 1 (2017): 57–65.
[17] Tendulkar, M.P., and S.S. Ninave. “Prospective Comparison of Pressor and Airway Responses to IV Esmolol and IV Dexmedetomidine during Emergence from General Anaesthesia and Extubation.” Journal of Krishna Institute of Medical Sciences University 6, no. 1 (2017): 49–56.
[18] Khatib, M.N., R. Kirubakaran, S. Gaidhane, A.H. Shankar, and Z. Quazi Syed. “Yoga for Improving Functional Capacity, Quality of Life and Cardiovascular Outcomes in People with Heart Failure.” Cochrane Database of Systematic Reviews 2017, no. 7 (2017). https://doi.org/10.1002/14651858.CD012015.pub2.
[19] Khatib, M.N., A. Gaidhane, S. Gaidhane, and Z.S. Quazi. “Ghrelin as a Promising Therapeutic Option for Cancer Cachexia.” Cellular Physiology and Biochemistry 48, no. 5 (2018): 2172–88. https://doi.org/10.1159/000492559.
[20] Belekar, V. “A Comparative Study to Evaluate the Efficacy of Butorphanol as an Adjuvant to Epidural Analgesia for Rib Fractures.” Journal of Datta Meghe Institute of Medical Sciences University 12, no. 3 (2017): 166–69. https://doi.org/10.4103/jdmimsu.jdmimsu_105_17.
[21] Bhalerao, N.S., A. Modak, and V. Belekar. “Comparison between Magnesium Sulfate (50 Mg/Kg) and Lignocaine (2 Mg/Kg) for Attenuation of Intubation Response in Hypertensive Patients.” Journal of Datta Meghe Institute of Medical Sciences University 12, no. 2 (2017): 118–20. https://doi.org/10.4103/jdmimsu.jdmimsu_58_17.
[22] Jejani AS, Chaudhari A, Singam A. Study of intrathecal buprenorphine for postoperative analgesia after cesarean section. Res J Pharm Technol 2019;12(12):6062-6066.
[23] Deopujari S, Shrivastava A, Joshi AG, Meshram A, Chaudhary S. Algoman: Gearing up for the “Net Generation” and Era of Artificial Intelligence, One Step at a Time. Indian J Pediatr 2019;86(12):1079-1080.
[24] Jain S, Singh P, Methwani D, Kalambe S. Role of Eustachian Dysfunction and Primary Sclerotic Mastoid Pneumatisation Pattern in Aetiology of Squamous Chronic Otitis Media: A Correlative Study. Indian J Otolaryngol Head Neck Surg 2019;71:1190-1196.
[25] Anjankar S, Anjankar SD. Do All Displaced Midline Ectodermal Cells Assimilate into Epidermoid Cysts? Neurol India 2019;67(6):1551-1552.
[26] Mahalle S. Osteoma of external auditory canal associated with external auditory canal cholesteatoma and exuberant granulation tissue in mastoid air cell system: a rare association. Indian J Otolaryngol Head Neck Surg 2019;71:1505-1507.
[27] Patond S, Mohite P, Ninave S, Wankhade P, Pande V. Age related changes in accidental contusion at tertiary care centre. Indian J Forensic Med Toxicol 2019;13(4):33-36.
[28] Wankhade PA, Patond SK, Tirpude BH. Roentgenographic evaluation of bones at wrist joint for osteological maturity for academic and judicial intrest. Indian J Forensic Med Toxicol 2019;13(4):131-136.
[29] Singam AP, Chaudhary A, Shrey S. Anatomical landmark guided versus ultrasound-guided technique for subclavian vein cannulation in critically ill patients. J Krishna Inst Med Sci Univ 2019;8(4):50-57.
[30] Chintalwar RS, Patond S, Ninave S. Estimation of time since death from postmortem lividity. Indian J Forensic Med Toxicol 2019;13(4):164-166.
[31] Rathi N, Taksande B, Kumar S. Nerve conduction studies of peripheral motor and sensory nerves in the subjects with prediabetes. J Endocrinol Metab 2019;9(5):147-150.
[32] Dubey YK, Damke S. Baby monitoring system using image processing and IoT. Int J Eng Adv Technol 2019;8(6):4961-4964.
[33] Jain S, Gaurkar S, Deshmukh PT, Khatri M, Kalambe S, Lakhotia P, et al. Applied anatomy of round window and adjacent structures of tympanum related to cochlear implantation. Brazilian J Otorhinolaryngol 2019;85(4):435-446.
[34] Jagati A, Chaudhary R, Rathod S, Madke B, Baxi K, Kasundra D. Preparation of platelet-rich fibrin membrane over scaffold of collagen sheet, its advantages over compression method: A novel and simple technique. J Cutan Aesthet Surg 2019;12(3):174-178.
[35] Kumar S, Jain S, Wanjari A, Mandal S. Development and validation of a modified frailty risk index as a predictor of mortality in rural elderly people. Asian J Gerontol Geriatr 2019;14(1):15-22.
[36] Chaudhry P, Jaiswal A. Secondary live abdominal ectopic pregnancy: A case report. World J Laparoscopic Surg 2019;12(2):86-87.
[37] Agrawal D, Bhake AS, Rastogi N, Laishram S, Wankhade A, Agarwal A. Role of Bethesda system for reporting thyroid lesion and its correlation with histopathological diagnosis. J Datta Meghe Inst Med Sci Univ 2019;14(2):74-81.
[38] Sen B, Chaudhary A, Sen J. Hemodynamic changes with intravenous dexmedetomidine and intravenous esmolol for attenuation of sympathomimetic response to laryngoscopy and tracheal intubation in neurosurgical patients: A comparative study. J Datta Meghe Inst Med Sci Univ 2019;14(2):67-73.
[39] Khanam N, Wagh V, Gaidhane AM, Quazi SZ. Knowledge, attitude and practice on uses of plastic products, their disposal and environmental pollution: A study among school-going adolescents. J Datta Meghe Inst Med Sci Univ 2019;14(2):57-60.
[40] Chaudhary KS, Phatak SV. Choroidal melanoma in a young patient ultrasonography and magnetic resonance imaging. J Datta Meghe Inst Med Sci Univ 2019;14(2):106-108.
[41] Phatak S, Shrivastav D, Marfani G, Daga S, Madurwar K, Samad S. Transvaginal sonography and elastography evaluation of ectopic pregnancy. J Datta Meghe Inst Med Sci Univ 2019;14(2):86-89.
[42] Madurwar KA, Phatak SV. Benign fibrous histiocytoma of male breast: Ultrasonography, doppler, and elastography imaging with pathological correlation. J Datta Meghe Inst Med Sci Univ 2019;14(2):103-105.
[43] Swarnkar M. Giant calcifying aponeurotic fibroma of web space: case report with review of literature. J Krishna Inst Med Sci Univ 2019;8(2):99-102.
[44] Dhatrak AA, Chaudhary K, Singh BR, Gajbe U. Evaluation of intensive pulse polio immunization in Solapur District. J Datta Meghe Inst Med Sci Univ 2019;14(2):82-85.
[45] Agrawal M, Acharya N, Joshi K, Shrivastava D. Effectiveness of isosorbide mononitrate in cervical ripening before induction of labor in full-term antenatal patients. J SAFOG 2019;11(2):96-99.
[46] Walinjkar RS, Khadse S, Kumar S, Bawankule S, Acharya S. Platelet Indices as a Predictor of Microvascular Complications in Type 2 Diabetes. Indian J Endocrinol Metab 2019;23(2):206-210.
[47] Sharma SK, Dheda K. What is new in the WHO consolidated guidelines on drug-resistant tuberculosis treatment? Indian J Med Res 2019;149(3):309-312.
[48] Varyani UT, Shah NM, Shah PR, Kute VB, Balwani MR, Trivedi HL. C1q nephropathy in a patient of neurofibromatosis type 1: A rare case report. Indian J Nephrol 2019;29(2):125-127.
[49] Dangore Khasbage S, Bhake AS. Cervical lymphadenopathy in a dental patient: An eye opener case report. Spec Care Dent 2019;39(1):59-64.
[50] Henry D, Singh A, Madke B, Kedia P. A case of altered clinical picture of extensive tinea corporis (Tinea as a great mimicker). Iran J Dermatol 2019;22(3):107-109.
[51] Patond S, Mohite P, Ninave S, Pande V. Knowledge about medicolegal aspect of documentation amongst residents and faculty-a cross-sectional study. J Indian Acad Forensic Med 2019;41(2):117-119.
[52] Singh R, Singam A. Comparative evaluation of dexmedetomedine versus clonidine as an adjuvant in supraclavicular brachial plexus block. J Krishna Inst Med Sci Univ 2019;8(3):53-65.
[53] Jain S, Deshmukh PT, Lakhotia P, Kalambe S, Chandravanshi D, Khatri M. Anatomical study of the facial recess with implications in round window visibility for cochlear implantation: Personal observations and review of the literature. Int Arch Otorhinolaryngol 2019;23(3):E281-E291.
[54] Deshpande SS, Phatak SV. A rare case of bilateral multiple ovarian dermoids with uterine fibroid and ectopic kidney. J Datta Meghe Inst Med Sci Univ 2019;14(1):39-41.
[55] Bajaj A, Kumar S, Inamdar AH, Agrawal L. Noninvasive ventilation in acute hypoxic respiratory failure in medical intensive care unit: A study in rural medical college. Intl J Crit Illn Inj Sci 2019;9(1):36-42.
[56] Aglawe PB, Jha RK, Mishra V, Sakore KM, Chetan A, Shrivastava DS. Appraisal of core therapy, supportive therapy, and alternative therapy in a tertiary care rural hospital of vidarbha region in correlation to plethora of menopausal problems. J Mid-Life Health 2019;10(1):14-21.
[57] Wankhade A, Vagha S, Shukla S, Bhake A, Laishram S, Agrawal D, et al. To correlate histopathological changes and transvaginal sonography findings in the endometrium of patients with abnormal uterine bleeding. J Datta Meghe Inst Med Sci Univ 2019;14(1):11-15.
[58] Patond S, Nagrale N, Jain K. Correlation between stature and skull dimensions in the population of central india: A cross sectional study. J Forensic Med Toxicol 2019;36(1):56-58.
[59] Nagrale N, Patond S, Jain K. Estimation of cephalic index of chhattisgarhi population: An anthropometric study from central India. J Forensic Med Toxicol 2019;36(1):9-12.
[60] Shrivastava D, Master A. Fetal Growth Restriction. J Obstet Gynecol India 2019.
[61] Khanam N, Wagh V, Gaidhane AM, Quazi SZ. Assessment of work-related musculoskeletal morbidity, perceived causes and preventive activities practiced to reduce morbidity among brick field workers. Ind J Community Health 2019;31(2):213-219.
[62] Swarnkar M, Jindal R. Obstructed obturator hernia: A diagnostic dilemma. J Krishna Inst Med Sci Univ 2019;8(3):115-117.
[63] Marfani G, Phatak SV, Madurwar KA, Samad S. Role of sonoelastography in diagnosing endometrial lesions: Our initial experience. J Datta Meghe Inst Med Sci Univ 2019;14(1):31-35.
[64] Gulve SS, Phatak SV. Parathyroid adenoma: Ultrasonography, Doppler, and elastography imaging. J Datta Meghe Inst Med Sci Univ 2019;14(1):47-49.
[65] Bhayani P, Rawekar R, Bawankule S, Kumar S, Acharya S, Gaidhane A, et al. Profile of urinary tract infection in a rural tertiary care hospital: Two-year cross-sectional study. J Datta Meghe Inst Med Sci Univ 2019;14(1):22-26.
[66] Laishram S, Gupta V, Bhake A, Wankhede A, Agrawal D. To assess the utility of proliferative marker Ki-67 in surface epithelial ovarian tumor. J Datta Meghe Inst Med Sci Univ 2019;14(1):6-10.
[67] Swarnkar K, Gaikwad S, Uke P, Vagha K, Dalal Y. Apert syndrome presenting with omphalocele. J Krishna Inst Med Sci Univ 2019;8(1):95-99.
[68] Balwani MR, Pasari A, Tolani P. Widening spectrum of renal involvement in psoriasis: First reported case of C3 glomerulonephritis in a psoriatic patient. Saudi J Kidney Dis Transpl 2019;30(1):258-260.
[69] Balwani MR, Bawankule CP, Pasari A, Tolani P, Vakil S, Yadav R. Minimal change disease and Kimura's disease responding to tacrolimus therapy. Saudi J Kidney Dis Transpl 2019;30(1):254-257.
[70] Balwani MR, Bawankule CP, Khetan P, Pasari A. Awareness about kidney and its related function/dysfunction in school going children: A survey from the Central India. Saudi J Kidney Dis Transpl 2019;30(1):202-207.
[71] Sharma SK, Mohan A, Singh AD, Mishra H, Jhanjee S, Pandey RM, et al. Impact of nicotine replacement therapy as an adjunct to anti-tuberculosis treatment and behaviour change counselling in newly diagnosed pulmonary tuberculosis patients: An open-label, randomised controlled trial. Sci Rep 2018;8(1).
[72] Ali, A., Hulipalled, V. R., Patil, S. S., & Kappaparambil, R. A. (2019). DPCCG-EJA: Detection of key pathways and cervical cancer related genes using enhanced Johnson’s algorithm. International Journal of Advanced Science and Technology, 28(1), 124-138. Retrieved from www.scopus.com
[73] Anitha, R., Ramesh, K. V., & Sudheerkumar, K. H. (2019). Synthesis, characterization of CeO2 nanoparticles via eco-friendly green combustion technique and its antimicrobial, anticancer activities. International Journal of Advanced Science and Technology, 28(7), 74-96. Retrieved from www.scopus.com
[74] Bindu Madhavi, G., & Rakesh Reddy, J. (2019). Detection and diagnosis of breast cancer using machine learning algorithm. International Journal of Advanced Science and Technology, 28(14), 228-237. Retrieved from www.scopus.com
[75] Kingsly, A. A. S., & Mahil, J. (2019). Effective approach of learning based classifiers for skin cancer diagnosis from dermoscopy images. International Journal of Advanced Science and Technology, 28(20), 1016-1026.
Retrieved from www.scopus.com
[76] Kumar, A., Sushil, R., & Tiwari, A. K. (2019). Feature extraction and elimination using machine learning algorithm for breast cancer biological datasets. International Journal of Advanced Science and Technology, 28(20), 425-435. Retrieved from www.scopus.com
[77] Lakshmi Prasanna, K., & Ashwini, S. (2019). Automatic breast cancer detection and classification using deep learning techniques. Test Engineering and Management, 81(11-12), 5505-5510. Retrieved from www.scopus.com
[78] Shin, B., Wang, B., & Lim, J. S. (2019). Feature selection and machine learning method for classification of lung cancer types. Test Engineering and Management, 81, 2307-2314. Retrieved from www.scopus.com
[79] Ghuge, K. S., Korabu, K. S., & Somani, A. (2020). Breast cancer detection using clustering and SVM. Test Engineering and Management, 83, 2196-2205.
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