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Prevention of laryngospasm with rocuronium in cats: a dose-finding study

      Abstract

      Objective

      To identify the dose of rocuronium that will prevent a laryngeal response to water spraying of the glottis in anesthetized cats.

      Study design

      Randomized crossover study.

      Animals

      Eight healthy, adult, short-haired cats, aged 1–4 years, weighing 3.2–6.0 kg.

      Methods

      Each cat was anesthetized four times and administered one of four doses of rocuronium (0.1, 0.2, 0.3 and 0.6 mg kg−1) in random order. The larynx was observed with a video-endoscope inserted through a laryngeal mask airway. Video-clips of the laryngeal response to a sterile water spray (0.2 mL) were obtained at baseline (without rocuronium) and at maximal effect of each treatment. Glottal closure score (0–2), duration of glottal closure, and number of adductive arytenoid movements were obtained from video-clips of laryngeal responses (reproduced in slow motion) at baseline and after treatment. Two observers blinded to treatment allocation scored the vigor of the laryngeal response on a visual analog scale (VAS). The duration of apnea (up to 5 minutes) was recorded for each treatment.

      Results

      Compared with baseline, rocuronium 0.3 mg kg−1 and 0.6 mg kg−1 significantly decreased all glottal scores obtained from the videos (all p < 0.03). Both observers gave lower VAS scores after 0.3 mg kg−1 (both p = 0.015). Apnea lasting ≥ 5 minutes occurred in none, one, three and seven of eight cats administered doses of rocuronium 0.1, 0.2, 0.3 and 0.6 mg kg−1, respectively.

      Conclusions and clinical relevance

      Rocuronium 0.3 mg kg−1 and 0.6 mg kg−1 consistently decreased the completeness and duration of the laryngeal response to water spray, and reduced the number of arytenoid adductive movements in response to that stimulus. However, a laryngeal response was never completely prevented. Rocuronium 0.3 mg kg−1 may be useful for facilitating tracheal intubation. Positive pressure ventilation must be available for cats administered rocuronium.

      Keywords

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      References

        • Auer U
        • Mosing M
        A clinical study of the effects of rocuronium in isoflurane‐anaesthetized cats.
        Vet Anaesth Analg. 2006; 33: 224-228
        • Barclay K
        • Eggers K
        • Asai T
        Low‐dose rocuronium improves conditions for tracheal intubation after induction of anaesthesia with propofol and alfentanil.
        Br J Anaesth. 1997; 78: 92-94
        • Claudius C
        • Skovgaard LT
        • Viby‐Mogensen J
        Acceleromyography and mechanomyography for establishing potency of neuromuscular blocking agents: a randomized controlled trial.
        Acta Anaesthesiol Scand. 2009; 53: 449-454
        • Combes X
        • Andriamifidy L
        • Dufresne E
        • et al.
        Comparison of two induction regimens using or not using muscle relaxant: impact on postoperative upper airway discomfort.
        Br J Anaesth. 2007; 99: 276-281
        • Dhonneur G
        • Rebaine C
        • Slavov V
        • et al.
        Neostigmine reversal of vecuronium neuromuscular block and the influence of renal failure.
        Anesth Analg. 1996; 82: 134-138
        • Hemmerling TM
        • Schmidt J
        • Wolf T
        • et al.
        Comparison of succinylcholine with two doses of rocuronium using a new method of monitoring neuromuscular block at the laryngeal muscles by surface laryngeal electromyography.
        Br J Anaesth. 2000; 85: 251-255
        • Hofmeister EH
        • Trim CM
        • Kley S
        • et al.
        Traumatic endotracheal intubation in the cat.
        Vet Anaesth Analg. 2007; 34: 213-216
        • Iwasaki H
        • Igarashi M
        • Omote K
        • et al.
        Vecuronium neuromuscular blockade at the cricothyroid and posterior cricoarytenoid muscles of the larynx and at the adductor pollicis muscle in humans.
        J Clin Anesth. 1994; 6: 14-17
        • Martin‐Flores M
        • Sakai DM
        • Campoy L
        • et al.
        Recovery from neuromuscular block in dogs: restoration of spontaneous ventilation does not exclude residual blockade.
        Vet Anaesth Analg. 2014; 41: 269-277
        • Martin‐Flores M
        • Cheetham J
        • Campoy L
        • et al.
        Effect of gantacurium on evoked laryngospasm and duration of apnea in anesthetized healthy cats.
        Am J Vet Res. 2015; 76: 216-223
        • Mencke T
        • Echternach M
        • Kleinschmidt S
        • et al.
        Laryngeal morbidity and quality of tracheal intubation: a randomized controlled trial.
        Anesthesiology. 2003; 98: 1049-1056
        • Michalek‐Sauberer A
        • Gilly H
        • Steinbereithner K
        • et al.
        Effects of vecuronium and rocuronium in antagonistic laryngeal muscles and the anterior tibial muscle in the cat.
        Acta Anaesthesiol Scand. 2000; 44: 503-510
        • Moreno‐Sala A
        • Ortiz‐Martinez R
        • Valdivia AG
        • et al.
        Use of neuromuscular blockade with rocuronium bromide for intubation in cats.
        Vet Anaesth Analg. 2013; 40: 351-358
        • Pilla T
        Studio della farmacocinetica del Propofol, progettazione e validazione di un sistema di target controlled infusion nel gatto.
        (Accessed 01 September, 2015.)
        • Rex MA
        The effects of other drugs on the stimulation of laryngospasm in the cat: atropine; thiopentone, suxamethonium; local analgesics.
        Br J Anaesth. 1971; 43: 117-121