Findings of the neuromuscular blocking agent rocuronium in blood from deceased subjects several months after exposure: A report of two cases.

Forensic Sci Int

Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Clinical Pharmacology, St. Olav University Hospital, Trondheim, Norway. Electronic address:

Published: June 2023

Rocuronium is a neuromuscular blocking agent mainly used in anesthetic procedures. Two patients who died 53 and 76 days, respectively, after their last rocuronium exposure had low (0.002-0.007 mg/L) levels of the drug in femoral blood, urine and vitreous humor samples obtained at autopsy. In neither case, the cause of death was related to the exposure to rocuronium. Here, these two cases are presented and the implications of the findings discussed.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.forsciint.2023.111680DOI Listing

Publication Analysis

Top Keywords

neuromuscular blocking
8
blocking agent
8
findings neuromuscular
4
rocuronium
4
agent rocuronium
4
rocuronium blood
4
blood deceased
4
deceased subjects
4
subjects months
4
months exposure
4

Similar Publications

Upstream open reading frames (uORFs) are -regulatory motifs that are predicted to occur in the 5' UTRs of the majority of human protein-coding transcripts and are typically associated with translational repression of the downstream primary open reading frame (pORF). Interference with uORF activity provides a potential mechanism for targeted upregulation of the expression of specific transcripts. It was previously reported that steric block antisense oligonucleotides (ASOs) can bind to and mask uORF start codons to inhibit translation initiation, and thereby disrupt uORF-mediated gene regulation.

View Article and Find Full Text PDF

Long-term Complications From Peripheral Nerve Blocks After Pediatric Orthopaedic Lower Extremity Procedures: A Systematic Review.

Am J Sports Med

January 2025

Department of Orthopaedic Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA; Orthopaedic Institute for Children, Los Angeles, California, USA; Boulder Medical Center, Boulder, Colorado, USA.

Article Synopsis
  • Peripheral nerve blocks (PNBs) are commonly used in pediatric orthopedic surgery for pain management and quicker discharge, but they can lead to both short- and long-term complications.
  • A systematic review identified 16 studies (10% of those reviewed) that discussed long-term complications following PNBs in pediatric patients, with 9 reporting issues such as chronic pain, motor deficits, and reduced range of motion.
  • Overall, complications were noted in a small percentage of patients, with chronic pain occurring in 5%, strength deficits in 10%, and sensory deficits in just 0.07%.
View Article and Find Full Text PDF

Prescription-event monitoring (PEM) is the current gold standard for determining the risk of rare drug side-effects and comparing the risk between agents; however, spontaneous or prompted reporting schemes have low case-detection rates and exposure may be difficult to estimate. A novel method is described that allows a comparative adverse event rate between two drugs to be estimated-based on patterns of cross-reactivity-requiring only a sample of cases and no direct knowledge of drug exposure rates. Agreement was compared between the novel method and historical estimates of risk using PEM for comparative risk of rocuronium versus vecuronium anaphylaxis.

View Article and Find Full Text PDF

Background: Using neuromuscular blocking agents (NMBA) in pediatric induction protocol is a challenging matter. Therefore, in this study, we aimed to find a safer way for anesthesia in children. We compared the effects of dexmedetomidine with atracurium on intubation conditions in children aged 6-12 years under general anesthesia.

View Article and Find Full Text PDF
Article Synopsis
  • Skeletal muscle relaxants are commonly used in anesthesia for surgeries, mechanical ventilation, and intubation, creating a conduction block at the neuromuscular junction.
  • Reversal agents, like neostigmine and sugammadex, help terminate the neuromuscular blockade and prevent residual effects, but their efficacy can be affected by liver and kidney dysfunction.
  • Liver damage, which can stem from various causes including drug toxicity and metabolic disorders, impairs drug metabolism and can lead to systemic complications, ultimately impacting the use of muscle relaxants in patients with liver disease.
View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!