Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942005000400001
Brazilian Journal of Anesthesiology
Scientific Article

Efeitos da lidocaína por via venosa sobre a farmacodinâmica do rocurônio

Effects of intravenous lidocaine on the pharmacodynamics of rocuronium

Leandro Sotto Maior Cardoso; César Romão Martins; Maria Angela Tardelli

http://dx.doi.org/10.1590/S0034-70942005000400001 Braz J Anesthesiol, vol.55, n4, p.371-380, 2005
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Resumo

JUSTIFICATIVA E OBJETIVOS: O rocurônio é um bloqueador neuromuscular (BNM) não-despolarizante de ação intermediária que apresenta início de ação mais rápido, indicado para situações onde há necessidade de intubação traqueal rápida. A lidocaína é freqüentemente utilizada por via venosa para diminuir as respostas hemodinâmicas associadas à intubação traqueal. A associação de um BNM a um anestésico local resulta em potencialização dos efeitos bloqueadores neuromusculares. O objetivo deste estudo é avaliar a interação entre a lidocaína e a farmacodinâmica do rocurônio avaliada por aceleromiografia. MÉTODO: Pacientes estado físico ASA I e II, com idade entre 18 e 65 anos, aleatoriamente distribuídos em dois grupos (GC: controle e GL: lidocaína), receberam rocurônio como bloqueador neuromuscular. O GL recebeu lidocaína (1,5 mg.kg-1) 3 minutos antes do rocurônio. A função neuromuscular foi avaliada pela resposta do músculo adutor do polegar à seqüência de quatro estímulos (SQE). Após a injeção do BNM foram anotados os tempos para a primeira resposta (T1) até a SQE atingir 10% e 0% do valor controle, e recuperar 25%, 75% e 95% da altura de contração (Dur25%, Dur75%, Dur95%). Anotou-se também o tempo de recuperação de T4/T1 = 0,8) e os intervalos Dur75%-Dur25% (IR25-75) e T4/T1 = 0,8 - Dur25%. RESULTADOS: Este estudo não demonstrou diferença estatística significativa entre os grupos quando comparados T1= 10%, T1 = 0, IR25-75, T4/T1 = 0,8 - Dur25%. Os tempos para Dur25%, Dur75%, Dur95% no GL foram estatisticamente superiores aos do GC. CONCLUSÕES: A associação de lidocaína ao rocurônio prolongou a fase inicial de recuperação do bloqueio sem interferir com o início de ação ou com a fase de recuperação final.

Palavras-chave

ANESTÉSICOS, ANESTÉSICOS, BLOQUEADORES NEUROMUSCULARES, BLOQUEADORES NEUROMUSCULARES

Abstract

BACKGROUND AND OBJECTIVES: Rocuronium is an intermediate nondepolarizing neuromuscular blocker (NMB) with faster onset and indicated in situations requiring rapid tracheal intubation. Intravenous lidocaine is often used to decrease hemodynamic responses to tracheal intubation. The association of NMB to local anesthetics results in potentiation of NMB effects. The purpose of this study was to evaluate the influence of lidocaine on rocuronium's pharmacodynamics determined by acceleromyography. METHODS: Forty-six ASA I-II patients, aged 18 to 65 years, were randomly distributed in two groups (CG: control and LG: lidocaine). Rocuronium was given to all patients for neuromuscular block. LG received lidocaine (1.5 mg.kg-1) 3 minutes before rocuronium. Neuromuscular function was evaluated by adductor pollicis muscle response to TOF. After NMB injection, times for first TOF response (T1) to reach 10 and 0% of baseline value and recover 25%, 75% and 95% of contraction height (Dur25%, Dur75%, Dur95%) were recorded. Recovery time of T4/T1 = 0.8 and intervals Dur75%-Dur25% (IR25-75) and T4/T1 = 0.8 - Dur25% were also recorded. RESULTS: This study has not shown statistically significant differences between groups when T1= 10%, T1 = 0, RI25-75, T4/T1 = 0.8 - Dur25% were compared. Times for Dur25%, Dur75%, Dur95% in LG were significantly higher as compared to CG. CONCLUSIONS: Lidocaine associated to rocuronium has prolonged early blockade recovery stage without interfering with onset or late recovery stage.

Keywords

ANESTHETICS, ANESTHETICS, NEUROMUSCULAR BLOCKERS, NEUROMUSCULAR BLOCKERS

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