الفهرس 
AIM OF WORKSOnly 14 pages are availabe for public view
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Abstract
Our study comprised 40 patients undergoing elective surgical proceduers needing muscle relaxation. These patients were divided according to the type of muscle relaxant into two groups each group comprises twenty patients :Group (A) Rocuronium group.Group (B) Pipecuronium group.Each was subdivided into two subgroups each onc comprises ten patients.Subgroup I(Normal patients).Subgroup II (cirrhotic patients).In each group the normal and cirrhotic subgroups were identical for age,and sex.All the patients were screened for haernatocrite, serum creatinine,serum urea nitrogen serum glutamic oxaloceuc transaminase (SGOT),serum glutamic pyruvic transaminase (SGPT) .serum gamma glutamyl transpeptidase (SOOT), total serum bilirubin, serum albumin and prothrombin time.All the patients were monitored for E.C.G, Oxymeter, end -tidal CO 2,blood pressure and train of four for assessment of recovery of neuromuscular function.All patients received general anaesthesia where induction was made by fentanyl 3-6 j.Lglkg,thiopental sodium 4-7 mg/ kg then muscle relaxant was given either rocuronium 0.6 mg/ kg or pipecuronium 0.1 rug/kg followed by endotracheal intubation and maintainamce of anaesthesia by nitrous.oxide 60% in oxygen 40% with intermittent doses of fentanyl when needed.Ventieation was centrolled keeping the end-tidal CO2 from 4.6-5.4 KPa.Central and peripheral temprature were kept above 32°C.Blood samples were taken at 0,2,5,10,i5:~0,45,60.75,90,120,150, 180,-240,300,360 minutes from the injection of muscle relaxant.Blood samples were contrifuged. Plasma was pipetted in clean glass tube and mixed with a 1 molar NaH2 P04 buffer. For1011 plasma 0.2 ml ’buffer’was added. The samples were stored at - 18°C.The concentrations of rocuronium and pipecuronium were analysed by high performance liquid chromatography the detection limit was 5 ng/ml,Plasma clearance, elimination half life and volume of distribution at steady state were determined on the basis of time course of plasma concentration by the use of program SIPHAR. All data were analysed by means of unpaired Student’s t-test. P values 0.05 were considered significant.In rocuronium group the onset time was shorter than other nondepolarising muscle relaxants in normal patients. However. there was a significant difference in onset time attributed to enlarged volume of distribution there was no significant difference up to recoveny of 25% of response which is defined as the clinical duration, while, the recovery of 75% and 90% was significantly increased. The only pharmacokinetic parameter that was different significantly was the volume of distribution Plasma clearance and elimination half life was not changed. All the above data and abscence of detected metabolites and abscence of human data on biliary excretion agree with our opinion tha~there is no great difference in use of rocuronium in cirrhotic patients.In pipecuronium group we didnot find any significant difference in neither onset time, nor recoveny times up to 10%and 2~% of twitch height.