TYK45 - Revision history

WikiSysop at 22:44, 23 January 2022

2022-01-23T22:44:17Z

← Older revision		Revision as of 22:44, 23 January 2022
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	Which one of the following neuromuscular blocking agents (NMBA) can increase heart rates via vagolysis in children at normal intubation doses?		Which one of the following neuromuscular blocking agents (NMBA) can increase heart rates via vagolysis in children at normal intubation doses?

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	D. Cisatracurium		D. Cisatracurium
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	==Answer==		==Answer==
	The answer is A. The vagolytic effects of NMBA are well known. This phenomenon is most well known and associated with pancuronium. However, at two times the ED95, increases in heart rate are seen with pancuronium and rocuronium in children. I seem to always see the heart rate rise when giving rocuronium. These agents seem to have less affect on the heart rate of infants. The ED95 of rocuronium is 0.31 mg/kg so a normal dose of 0.6 mg/kg is 2 times the ED95. Atracurium MAY cause an increase in heart rate, but this is via a histamine release (not vagolysis). It may also cause bronchospasm, flushing, hypotension, etc. associated with histamine release. Cisatracurium does not cause significant histamine release. Vecuronium does not cause histamine release or vagolysis. However, it is the biggest offender for IgE-mediated anaphylaxis among the NMBA. NMBA caused the largest number of reactions in a recent study for intraoperative anaphylaxis.		The answer is A. The vagolytic effects of NMBA are well known. This phenomenon is most well known and associated with pancuronium. However, at two times the ED95, increases in heart rate are seen with pancuronium and rocuronium in children. I seem to always see the heart rate rise when giving rocuronium. These agents seem to have less affect on the heart rate of infants. The ED95 of rocuronium is 0.31 mg/kg so a normal dose of 0.6 mg/kg is 2 times the ED95. Atracurium MAY cause an increase in heart rate, but this is via a histamine release (not vagolysis). It may also cause bronchospasm, flushing, hypotension, etc. associated with histamine release. Cisatracurium does not cause significant histamine release. Vecuronium does not cause histamine release or vagolysis. However, it is the biggest offender for IgE-mediated anaphylaxis among the NMBA. NMBA caused the largest number of reactions in a recent study for intraoperative anaphylaxis.

	==Notes==		==Notes==
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	==Keywords==		==Keywords==
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WikiSysop: 1 revision imported

2021-03-20T16:48:30Z

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← Older revision	Revision as of 16:48, 20 March 2021
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https://pedsanesthesia.net/wikiOLD032021>JustinHamrick at 23:01, 6 March 2015

2015-03-06T23:01:46Z

New page

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Which one of the following neuromuscular blocking agents (NMBA) can increase heart rates via vagolysis in children at normal intubation doses?

A. Rocuronium

B. Atracurium

C. Vecuronium

D. Cisatracurium

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==Answer==
The answer is A. The vagolytic effects of NMBA are well known. This phenomenon is most well known and associated with pancuronium. However, at two times the ED95, increases in heart rate are seen with pancuronium and rocuronium in children. I seem to always see the heart rate rise when giving rocuronium. These agents seem to have less affect on the heart rate of infants. The ED95 of rocuronium is 0.31 mg/kg so a normal dose of 0.6 mg/kg is 2 times the ED95. Atracurium MAY cause an increase in heart rate, but this is via a histamine release (not vagolysis). It may also cause bronchospasm, flushing, hypotension, etc. associated with histamine release. Cisatracurium does not cause significant histamine release. Vecuronium does not cause histamine release or vagolysis. However, it is the biggest offender for IgE-mediated anaphylaxis among the NMBA. NMBA caused the largest number of reactions in a recent study for intraoperative anaphylaxis.

==Notes==
<references />

==Keywords==
:

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