Histamine is released by benzylisoquinolinium com- pounds such as mivacurium, atracurium and tubocurarine, causing skin flushing, decreases in arterial pressure and systemic vascular resistance and increases in heart rate [1–6].
Does Cisatracurium release histamine?
Cisatracurium, chemically an isomer of atracurium, is a benzylisoquinolinium-type muscle relaxant with an intermediate duration of action. Early clinical reports have shown that cisatracurium does not cause histamine release or clinically significant cardiovascular effects at doses of eight times its ED95(0.4 mg/kg).
Which muscle relaxants cause histamine release?
The results showed that gallamine, pancuronium, vecuronium, atracurium, tubocurarine and alcuronium produced concentration-dependent contractions in the rat ileum, gallamine and pancuronium being the most effective agents in producing muscle contraction.
Does vecuronium release histamine?
Vecuronium rarely produces significant release of endogenous histamine. Cannon and colleagues  noted that vecuronium resulted in direct release of large amounts of histamine in one of 20 patients in their study.
Does rocuronium cause histamine release?
Rocuronium has been shown to activate the MRGPRX2 receptor on mast cells, inducing a non-IgE- mediated histamine release, which explains its potential for causing pseudoallergic reactions.
Does succinylcholine cause histamine release?
As with other neuromuscular blocking agents, the potential for releasing histamine is present following succinylcholine administration. Signs and symptoms of histamine-mediated release such as flushing, hypotension, and bronchoconstriction are, however, uncommon in normal clinical usage.
Can you reverse Cisatracurium?
Cisatracurium binds to cholinergic receptors on the motor end-plate to antagonise the action of acetylcholine, resulting in a competitive block of neuromuscular transmission. This action is readily reversed by anti-cholinesterase agents such as neostigmine or edrophonium.
Which drugs cause histamine release?
Anaesthetic drugs that release histamine directly include atracurium, mivacurium, morphine and meperidine. Clinical evidence of histamine release, usually cutaneous, occurs in up to 30% of patients during anaesthesia.
How fast can you push rocuronium?
The recommended initial dose of rocuronium bromide, regardless of anesthetic technique, is 0.6 mg/kg. Neuromuscular block sufficient for intubation (80% block or greater) is attained in a median (range) time of 1 (0.4 to 6) minute(s) and most patients have intubation completed within 2 minutes.
How long does it take for rocuronium to work?
Rocuronium is a nondepolarizing paralytic agent that induces muscle paralysis by competitive antagonism at the acetyl-cholinergic receptor. Dosing of rocuronium can vary from 0.6—1.2 mg/kg. The onset of action is dose-dependent from 45—120 seconds, with a duration of action 30—90 minutes.
What is the duration of rocuronium?
With lower dosages of 0.3 – 0.45 mg rocuronium bromide per kg body weight (1 – 1 ½ x 2 x ED 90), the onset of the effect is slower and the duration of action is shorter (13 – 26 min). With high doses of 2 mg/kg, clinical duration is 110 minutes.