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Pharmacological Interventions for Acceleration of the Onset Time of Rocuronium: A Meta-Analysis
BACKGROUND: Rocuronium is an acceptable alternative when succinylcholine is contraindicated for facilitating the endotracheal intubation. However, the onset time of rocuronium for good intubation condition is still slower than that condition of succinylcholine. This study systematically investigated...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4252114/ https://www.ncbi.nlm.nih.gov/pubmed/25460931 http://dx.doi.org/10.1371/journal.pone.0114231 |
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author | Dong, Jing Gao, Lingqi Lu, Wenqing Xu, Zifeng Zheng, Jijian |
author_facet | Dong, Jing Gao, Lingqi Lu, Wenqing Xu, Zifeng Zheng, Jijian |
author_sort | Dong, Jing |
collection | PubMed |
description | BACKGROUND: Rocuronium is an acceptable alternative when succinylcholine is contraindicated for facilitating the endotracheal intubation. However, the onset time of rocuronium for good intubation condition is still slower than that condition of succinylcholine. This study systematically investigated the most efficacious pharmacological interventions for accelerating the onset time of rocuronium. METHODS: Medline, Embase, Cochrane Library databases, www.clinicaltrials.gov, and hand searching from the reference lists of identified papers were searched for randomized controlled trials comparing drug interventions with placebo or another drug to shorten the onset time of rocuronium. Statistical analyses were performed using RevMan5.2 and ADDIS 1.16.5 softwares. Mean differences (MDs) with their 95% confidence intervals (95% CIs) were used to analyze the effects of drug interventions on the onset time of rocuronium. RESULTS: 43 randomized controlled trials with 2,465 patients were analyzed. The average onset time of rocuronium was 102.4±24.9 s. Priming with rocuronium [Mean difference (MD) −21.0 s, 95% confidence interval (95% CI) (−27.6 to −14.3 s)], pretreatment with ephedrine [−22.3 s (−29.1 to −15.5 s)], pretreatment with magnesium sulphate [−28.2 s (−50.9 to −5.6 s)] were all effective in reducing the onset time of rocuronium. Statistical testing of indirect comparisons showed that rocuronium priming, pretreatment with ephedrine, and pretreatment with magnesium sulphate had the similar efficacy. CONCLUSION: Rocuronium priming, pretreatment with ephedrine, and pretreatment with magnesium sulphate were all effective in accelerating the onset time of rocuronium, and furthermore their efficacies were similar. Considering the convenience and efficacy, priming with rocuronium is recommended for accelerating the onset time of rocuronium. However, more strict clinical trials are still needed to reach a more solid conclusion due to the large heterogeneities exist among different studies. |
format | Online Article Text |
id | pubmed-4252114 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-42521142014-12-05 Pharmacological Interventions for Acceleration of the Onset Time of Rocuronium: A Meta-Analysis Dong, Jing Gao, Lingqi Lu, Wenqing Xu, Zifeng Zheng, Jijian PLoS One Research Article BACKGROUND: Rocuronium is an acceptable alternative when succinylcholine is contraindicated for facilitating the endotracheal intubation. However, the onset time of rocuronium for good intubation condition is still slower than that condition of succinylcholine. This study systematically investigated the most efficacious pharmacological interventions for accelerating the onset time of rocuronium. METHODS: Medline, Embase, Cochrane Library databases, www.clinicaltrials.gov, and hand searching from the reference lists of identified papers were searched for randomized controlled trials comparing drug interventions with placebo or another drug to shorten the onset time of rocuronium. Statistical analyses were performed using RevMan5.2 and ADDIS 1.16.5 softwares. Mean differences (MDs) with their 95% confidence intervals (95% CIs) were used to analyze the effects of drug interventions on the onset time of rocuronium. RESULTS: 43 randomized controlled trials with 2,465 patients were analyzed. The average onset time of rocuronium was 102.4±24.9 s. Priming with rocuronium [Mean difference (MD) −21.0 s, 95% confidence interval (95% CI) (−27.6 to −14.3 s)], pretreatment with ephedrine [−22.3 s (−29.1 to −15.5 s)], pretreatment with magnesium sulphate [−28.2 s (−50.9 to −5.6 s)] were all effective in reducing the onset time of rocuronium. Statistical testing of indirect comparisons showed that rocuronium priming, pretreatment with ephedrine, and pretreatment with magnesium sulphate had the similar efficacy. CONCLUSION: Rocuronium priming, pretreatment with ephedrine, and pretreatment with magnesium sulphate were all effective in accelerating the onset time of rocuronium, and furthermore their efficacies were similar. Considering the convenience and efficacy, priming with rocuronium is recommended for accelerating the onset time of rocuronium. However, more strict clinical trials are still needed to reach a more solid conclusion due to the large heterogeneities exist among different studies. Public Library of Science 2014-12-02 /pmc/articles/PMC4252114/ /pubmed/25460931 http://dx.doi.org/10.1371/journal.pone.0114231 Text en © 2014 Dong et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Dong, Jing Gao, Lingqi Lu, Wenqing Xu, Zifeng Zheng, Jijian Pharmacological Interventions for Acceleration of the Onset Time of Rocuronium: A Meta-Analysis |
title | Pharmacological Interventions for Acceleration of the Onset Time of Rocuronium: A Meta-Analysis |
title_full | Pharmacological Interventions for Acceleration of the Onset Time of Rocuronium: A Meta-Analysis |
title_fullStr | Pharmacological Interventions for Acceleration of the Onset Time of Rocuronium: A Meta-Analysis |
title_full_unstemmed | Pharmacological Interventions for Acceleration of the Onset Time of Rocuronium: A Meta-Analysis |
title_short | Pharmacological Interventions for Acceleration of the Onset Time of Rocuronium: A Meta-Analysis |
title_sort | pharmacological interventions for acceleration of the onset time of rocuronium: a meta-analysis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4252114/ https://www.ncbi.nlm.nih.gov/pubmed/25460931 http://dx.doi.org/10.1371/journal.pone.0114231 |
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