Publications by authors named "Akira Doshu-Kajiura"

2 Publications

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Extravascular leakage of induction doses of rocuronium: four cases in which both depth of neuromuscular block and plasma concentration of rocuronium were assessed.

J Clin Monit Comput 2021 Mar 21. Epub 2021 Mar 21.

Department of Anesthesiology, Nihon University School of Medicine, 30-1, Oyaguchi Kamimachi, Itabashi-Ku, Tokyo, 173-8610, Japan.

The duration of action of extravasated rocuronium varies depending on the patient's comorbidities. In patients who receive high doses of non-depolarizing neuromuscular blocking agents subcutaneously, anesthesiologists should be aware of unexpected prolongation of the progress and recovery of neuromuscular block. In such cases, the depth and recovery of neuromuscular block should be objectively monitored to avoid residual neuromuscular block and recurarization.
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http://dx.doi.org/10.1007/s10877-021-00692-2DOI Listing
March 2021

Prolonged onset and duration of action of rocuronium after accidental subcutaneous injection in a patient with chronic renal failure-a case report.

JA Clin Rep 2021 Feb 27;7(1):18. Epub 2021 Feb 27.

Department of Anesthesiology, Nihon University, School of Medicine, 30-1, Oyaguchi, Kami-cho, Itabashi-ku, Tokyo, 173-8610, Japan.

Background: Drugs administered subcutaneously have delayed onset and prolonged duration of action versus those given intravenously. Since the duration of action of rocuronium is prolonged in patients with renal dysfunction, subcutaneous administration of rocuronium to such patients might significantly prolong its effect.

Case Presentation: A 51-year-old female with chronic renal failure was accidentally administered 1.04 mg/kg rocuronium subcutaneously. Marked prolongation of onset and duration of action of rocuronium were detected on acceleromyography. Slow development of the neuromuscular block was still observed at 100 min after injection. Administration of 4.5 mg/kg sugammadex at 140 min after rocuronium injection facilitated recovery from a train-of-four (TOF) count of 2 to a TOF ratio of 100% within 5 min. No symptoms of postoperative recurarization and upper airway obstruction were observed.

Conclusion: Neuromuscular monitoring is necessary to evaluate the progress and depth of neuromuscular block, particularly when rocuronium is inadvertently administered subcutaneously.
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http://dx.doi.org/10.1186/s40981-021-00421-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914319PMC
February 2021