Experience With Lacosamide in a Series of Children With Drug-Resistant Focal Epilepsy

We report our pediatric experience with lacosarnide, a new antiepileptic drug, approved by the US Food and Drug Administration as adjunctive therapy in focal epilepsy in patients more than 17 years old. We retrospectively reviewed charts for lacosamide use and seizure frequency outcome in patients with focal epilepsy (Wilcoxon signed rank test). Sixteen patients (7 boys) were identified (median dose 275 mg daily, 4.7 mg/kg daily; mean age 14.9 years, range 8-21 years). Patients were receiving a median of 2 antiepileptic drugs (interquartile range [IQR] 1.7-3) in addition to having undergone previous epilepsy surgery (n = 3), vagus nerve stimulation (n = 9), and ketogenic diet (n = 3). Causes included structural (encephalomalacia and diffuse encephalitis, 1 each; stroke in 2) and genetic abnormalities (Aarskog and Rett syndromes, 1 each) or cause not known (n = 10). Median seizure frequency at baseline was 57 per month (IQR 7-75), and after a median follow-up of 4 months (range 1-13 months) of receiving lacosamide, it was 12.5 per month (IQR 3-75), (P < 0.01). Six patients (37.5%; 3 seizure free) were classified as having disease that responded to therapy (>= 50% reduction seizure frequency) and 10 as having disease that did not respond to therapy (<50% in 3; increase in 1; unchanged in 6). Adverse events (tics, behavioral disturbance, seizure worsening, and depression with suicidal ideation in 1 patient each) prompted lacosamide discontinuation in 4/16 (25%). This retrospective study of 16 children with drug-resistant focal epilepsy demonstrated good response to adjunctive lacosamide therapy (median seizure reduction of 39.6%; 37.5% with >= 50% seizure reduction) without severe adverse events. (C) 2011 Elsevier Inc. All rights reserved.

Complexation of the anti-Trypanosoma cruzi drug benznidazole improves solubility and efficacy

The ruthenium complex,trans-[Ru(Bz)(NH3)(4)SO2](CF3SO3)(2) 1, Bz = benznidazole (N-benzyl-2-(2-nitro-1H-imidazol-1-yl)acetamide), is more hydrosoluble and more active (IC50try/1 h = 79 +/- 3 mu M) than free benznidazole 2 (IC50try/1 h > 1 mM). 1 also exhibits low acute toxicity in vitro (IC50macrophages > 1 mM) and in vivo (400 mu mol/kg < LD50 < 600 mu mol/kg) and the formation of hydroxylamine is more favorable in 1 than in 2 by 9.6 kcal/mol. In murine acute models of Chagas` disease, 1 was more active than 2 even when only one dose was administrated. Moreover, 1 at a thousand-fold smaller concentration than the considered optimal dose for 2 (385 mu mol/kg/day = 100 mg/kg/day), proved to be sufficient to protect all infected mice, eliminating the amastigotes in their hearts and skeletal muscles as observed in H&E micrographics.

Chloroquine is grossly under dosed in young children with malaria : implications for drug resistance

Background: Plasmodium falciparum malaria is treated with 25 mg/kg of chloroquine (CQ) irrespective of age. Theoretically, CQ should be dosed according to body surface area (BSA). The effect of dosing CQ according to BSA has not been determined but doubling the dose per kg doubled the efficacy of CQ in children aged <15 years infected with P. falciparum carrying CQ resistance causing genes typical for Africa. The study aim was to determine the effect of age on CQ concentrations. Methods and Findings: Day 7 whole blood CQ concentrations were determined in 150 and 302 children treated with 25 and 50 mg/kg, respectively, in previously conducted clinical trials. CQ concentrations normalised for the dose taken in mg/kg of CQ decreased with decreasing age (p<0.001). CQ concentrations normalised for dose taken in mg/m(2) were unaffected by age. The median CQ concentration in children aged <2 years taking 50 mg/kg and in children aged 10-14 years taking 25 mg/kg were 825 (95% confidence interval [CI] 662-988) and 758 (95% CI 640-876) nmol/l, respectively (p = 0.67). The median CQ concentration in children aged 10-14 taking 50 mg/kg and children aged 0-2 taking 25 mg/kg were 1521 and 549 nmol/l. Adverse events were not age/concentration dependent. Conclusions: CQ is under-dosed in children and should ideally be dosed according to BSA. Children aged <2 years need approximately double the dose per kg to attain CQ concentrations found in children aged 10-14 years. Clinical trials assessing the efficacy of CQ in Africa are typically performed in children aged <5 years. Thus the efficacy of CQ is typically assessed in children in whom CQ is under dosed. Approximately 3 fold higher drug concentrations can probably be safely given to the youngest children. As CQ resistance is concentration dependent an alternative dosing of CQ may overcome resistance in Africa.

Suco de laranja e vitamina C : efeito sobre a estabilidade genômica

Existem evidências crescentes indicando a associação entre dietas ricas em frutas e vegetais e a diminuição da incidência de câncer. O suco de laranja (OJ) pode ser incluído entre os alimentos com potencial quimioprotetor e seu estudo é muito relevante pelo amplo consumo desta bebida. O OJ possui vários nutrientes e compostos bioativos com atividades antioxidante, antimutagênica, anticarcinogênica e antiaterogênica, entre outras. A vitamina C (Vit C) é um dos nutrientes mais abundantes no OJ, e o único nutriente que pode ser provido em quantidade superior à recomendação diária por uma única porção de 200 mL de OJ. A Vit C, a exemplo de outros componentes do OJ, pode ser tanto benéfica quanto maléfica para os sistemas biológicos, dependendo do contexto metabólico. Neste sentido, vários nutrientes presentes no OJ têm sido identificados como mutagênicos ou carcinogênicos, especialmente quando administrados de forma isolada. Este estudo utilizou o ensaio Cometa alcalino em sangue de camundongos (in vivo) para avaliar: 1) a genotoxicidade do OJ e da Vit C; 2) a genotoxicidade do FeSO4 e do CuSO4: 3) o efeito modulador do OJ e da Vit C sobre a genotoxicidade do FeSO4 e CuSO4, bem como do metilmetanosulfonato (MMS) e da ciclofosfamida (CP). A versão alcalina do ensaio Cometa foi utilizada para avaliar o dano no DNA em células brancas do sangue periférico de camundongos. Adicionalmente, os níveis de cobre e ferro no sangue e no fígado dos camundongos tratados com metais e OJ foram avaliados pela metodologia de PIXE (Particle-Induced X-ray Emission). Grupos com pelo menos 6 camundongos (metade de cada sexo) foram tratados por gavage com uma ou duas doses de água (controle), CP, MMS, FeSO4 ou CuSO4. OJ (0.1 mL/Kg) foi administrado tanto antes (pré-tratamento) quanto após a administração das substâncias-teste (pós-tratamento). A Vit C (1 e 30 mg/Kg) foi administrada apenas no pós-tratamento. O dano no DNA foi avaliado 24 e 48 h após o início do tratamento. Após 24 h, o OJ induziu um suave aumento no dano no DNA, enquanto a Vit C foi genotóxica (30 mg/Kg > 1 mg/Kg). O tratamento duplo com Vit C (a 0 e a 24 h) induziu uma resposta genotóxica cumulativa a 48 h, que foi mais intensa para a dose maior. O FeSO4 e o CuSO4 foram genotóxicos após 24 h, mas tiveram seu dano efetivamente reparado após 48 h do tratamento. O pré-tratamento com OJ reduziu a genotoxicidade do FeSO4 e do CuSO4 (efeito preventivo). O pós-tratamento com OJ também reduziu a genotoxicidade do CuSO4 (efeito reparador). O OJ mostrou tanto efeito preventivo quanto reparador sobre a genotoxicidade do MMS. O OJ teve apenas efeito reparador sobre a CP. Ambas doses de Vit C aumentaram os danos no DNA causados pelo FeSO4 e pelo CuSO4. Adicionalmente, os níveis de cobre e ferro no sangue e no fígado dos camundongos tratados com metais e OJ foram avaliados pela metodologia de PIXE (Particle-Induced X-ray Emission). Grupos com pelo menos 6 camundongos (metade de cada sexo) foram tratados por gavage com uma ou duas doses de água (controle), CP, MMS, FeSO4 ou CuSO4. OJ (0.1 mL/Kg) foi administrado tanto antes (pré-tratamento) quanto após a administração das substâncias-teste (pós-tratamento). A Vit C (1 e 30 mg/Kg) foi administrada apenas no pós-tratamento. O dano no DNA foi avaliado 24 e 48 h após o início do tratamento. Após 24 h, o OJ induziu um suave aumento no dano no DNA, enquanto a Vit C foi genotóxica (30 mg/Kg > 1 mg/Kg). O tratamento duplo com Vit C (a 0 e a 24 h) induziu uma resposta genotóxica cumulativa a 48 h, que foi mais intensa para a dose maior. O FeSO4 e o CuSO4 foram genotóxicos após 24 h, mas tiveram seu dano efetivamente reparado após 48 h do tratamento. O pré-tratamento com OJ reduziu a genotoxicidade do FeSO4 e do CuSO4 (efeito preventivo). O pós-tratamento com OJ também reduziu a genotoxicidade do CuSO4 (efeito reparador). O OJ mostrou tanto efeito preventivo quanto reparador sobre a genotoxicidade do MMS. O OJ teve apenas efeito reparador sobre a CP. Ambas doses de Vit C aumentaram os danos no DNA causados pelo FeSO4 e pelo CuSO4. processado e armazenado de forma a preservar o seu potencial biológico é um alimento sugerido como uma das porções de uma dieta equilibrada (contendo pelo menos 5 porções de frutas e vegetais), recomendada para uma vida saudável e longeva.

Determination of the highest no-effect dose (HNED) and of the elimination pattern for cocaine in horses

Cocaine is one of the most widespread illegal stimulants utilized by the human population throughout the world. The aim of this study was to establish the highest no-effect dose (HNED) of cocaine on the spontaneous locomotor activity (SLA) of horses in a behavior chamber, and thereby to determine the maximal acceptable threshold of the urinary drug concentration in horses. Twelve English thoroughbred mares received 0.02, 0.03, 0.04, 0.08 or 0.12 mg kg(-1) cocaine i.v. or saline solution (control). It was noted that doses above 0.04 mg kg(-1) induced a significant increase in SLA (P < 0.05, Tukey's test). No significant increase in SLA was seen in the mares that received 0.03 mg kg(-1), but the animals showed important behavioral changes that did not occur after the 0.02 mg kg(-1) dose. It was concluded that the HNED of cocaine for horses in a behavior chamber is 0.02 mg kg(-1). After injection of this dose in five horses, urine samples were collected at predetermined intervals through vesical catheterization. The concentrations of cocaine, norcocaine, benzoylecgonine and ecgonine methyl ester were quantified by liquid chromatography/electrospray ionization tandem mass spectrometry. Cocaine and norcocaine concentrations remained consistently below the level of detection. Benzoylecgonine reached a mean (+/- SEM) maximum concentration of 531.9 +/- 168.7 ng ml(-1) after 4 h, whereas ecgonine methyl ester peaked 2 h after injection at a concentration of 97.2 +/- 26.5 ng ml(-1). The maximum admissible concentration for cocaine and/or metabolites in the urine of horses is difficult to establish unequivocally because of the substantial individual variation in the drug elimination pattern observed in horses, which can be inferred by the large standard error of the means obtained. Copyright (C) 2002 John Wiley Sons, Ltd.

Inclusion complex of piroxicam with beta-cyclodextrin and incorporation in cationic microemulsion. In vitro drug release and in vivo topical anti-inflammatory effect

Topical formulations of piroxicam were evaluated by determination of their in vitro release and in vivo anti-inflammatory effect. The in vitro release assay demonstrated that the microemulsion (ME) systems provided a reservoir effect for piroxicam release. However, the incorporation of the ME into carboxyvinilic gel provoked a greater reduction in the release of piroxicam than the ME system alone. Anti-inflammatory activity was carried out by the cotton pellet granuloma inhibition bioassay. Topical anti-inflammatory effect of the piroxicam inclusion complex/ME contained in carboxyvinilic gel showed significant inhibition of the inflammation process (36.9%, P < 0.05). Subcutaneous administration of the drug formulations showed a significant effect on the inhibition of inflammation, 68.8 and 70.5%, P <0.05, when the piroxicam was incorporated in ME and in the combined system beta -cyclodextrin (B-CD)/ME, respectively, relative to the buffered piroxicam (42.2%). These results demonstrated that the ME induced prolonged effects, providing inhibition of the inflammation for 9 days after a single dose administration. (C) 2001 Elsevier B.V. B.V. All rights reserved.

Pharmacokinetics of intraosseous and central venous drug delivery during cardiopulmonary resuscitation

We compared the pharmacokinetics of intraosseous (IO) drug delivery via tibia or sternum, with central venous (CV) drug delivery during cardiopulmonary resuscitation (CPR).Methods: CPR of anesthetized KCl arrest swine was initiated 8 min post arrest. Evans blue and indocyanine green, each were simultaneously injected as a bolus with adrenaline through IO sternal and tibial needles, respectively, n = 7. In second group (n = 6) simultaneous IO sternal and IV central venous (CV) injections were made.Results: Peak arterial blood concentrations were achieved faster for sternal IO vs. tibial IO administration (53 +/- 11 s vs. 107 +/- 27 s, p = 0.03). Tibial IO dose delivered was 65% of sternal administration (p = 0.003). Time to peak blood concentration was similar for sternal IO and CV administration (97 +/- 17 s vs. 70 +/- 12 s, respectively; p = 0.17) with total dose delivered of sternal being 86% of the dose delivered via CV (p = 0.22).Conclusions: IO drug administrations via either the sternum or tibia were effective during CPR in anesthetized swine. However, IO drug administration via the sternum was significantly faster and delivered a larger dose. (C) 2011 Elsevier B.V. All rights reserved.

Effect of high-dose fentanyl on renal function in dogs

OBJETIVOS: Estudamos os efeitos de alta dose de fentanil (F) em atributos de função renal (FR) do cão. DESENHO: Anestesiamos com pentobarbital sódico (PS) 16 cães divididos aleatoriamente em 2 grupos: manutenção com PS (Gi) e PS com F (0,05 mg.kg-1) (G2). INTERVENÇÃO: os cães foram ventilados artificialmente e tiveram cateterizadas as veias femorais esquerda e direita e a artéria femoral esquerda para infusão de drogas e coleta de dados hemodinâmicos e de sangue para dosagens laboratoriais. Coletou-se urina durante todo experimento. MENSURAÇÃO: Determinaram-se os valores de atributos de FR.. RESULTADOS: PS não mudou a FR e o comportamento de G1 deveu-se à expansão do volume extracelular. O F diminuiu significativamente freqüência cardíaca, pressão arterial média, clearance de creatinina, volume urinário, clearance osmolar e excreção fracionária de sódio e potássio. CONCLUSÕES: A diminuição da FR foi provavelmente devida às alterações hemodinâmicas induzidas pelo F, não se descartando possível ação da aldosterona.

Intoxicação por metronidazol em cão - relato de caso

Metronidazole is a nitronidazolic antibiotic used in veterinary medicine to the treatment of a variety of diseases. The cause of metronidazole neurotoxicity has not been determined. We report the case of a dog, female, Teckel, five-year-old, with a history of dorsiflexion of the tail, ataxia, muscle stiffness, recumbency, vertical nystagmus, apathy and anorexia, which was being medicated for seven days with metronidazole in a dose higher than the maximum recommended, and the neurological signs began after this period. Neurological signs were consistent with central vestibular dysfunction caused by metronidazole, such as ataxia and vertical nystagmus. In addition to the neurological changes, the clinical signs of anorexia and apathy are consistent with the administration of excessive doses of the medicine. The diagnosis of metronidazole-induced toxicosis is based on the history of normal to increased doses, clinical signs and resolution after discontinuation of the drug. In general, the prognosis is good after drug withdrawal and early diagnosis. Some dogs may die and others may recover completely. The neurotoxicosis has disappeared after the suspension of the medicine and supportive treatment. Veterinarians must be aware of potential complications associated with the use of this medicine, as well as limit their chronic use or high doses for the most severe cases, and diagnose the problem as quickly as possible to institute an early treatment.

Short and long period optimization of drug doses in the treatment of AIDS

Técnicas de otimização numérica são úteis na solução de problemas de determinação da melhor entrada para sistemas descritos por modelos matemáticos e cujos objetivos podem ser expressos de uma maneira quantitativa. Este trabalho aborda o problema de otimizar as dosagens dos medicamentos no tratamento da AIDS em termos de um balanço entre a resposta terapêutica e os efeitos colaterais. Um modelo matemático para descrever a dinâmica do vírus HIV e células CD4 é utilizado para calcular a dosagem ótima do medicamento no tratamento a curto prazo de pacientes com AIDS por um método de otimização direta utilizando uma função custo do tipo Bolza. Os parâmetros do modelo foram ajustados com dados reais obtidos da literatura. Com o objetivo de simplificar os procedimentos numéricos, a lei de controle foi expressa em termos de uma expansão em séries que, após truncamento, permite obter controles sub-ótimos. Quando os pacientes atingem um estado clínico satisfatório, a técnica do Regulador Linear Quadrático (RLQ) é utilizada para determinar a dosagem permanente de longo período para os medicamentos. As dosagens calculadas utilizando a técnica RLQ , tendem a ser menores do que a equivalente terapia de dose constante em termos do expressivo aumento na contagem das células T+ CD4 e da redução da densidade de vírus livre durante um intervalo fixo de tempo.

Redução da dose e do volume de calda nas aplicações noturnas de herbicidas em pós-emergência na cultura de soja

O objetivo deste trabalho foi avaliar o efeito de reduções da dose e do volume de calda nas aplicações noturnas de herbicidas em pós-emergência sobre o controle de plantas daninhas e a seletividade para a cultura da soja. Dois experimentos foram conduzidos na Fazenda de Ensino e Pesquisa da FCAV/UNESP - Campus de Jaboticabal, durante os anos agrícolas de 94/95 e 95/96. As aplicações foram realizadas às 5, 9, 14, 17 e 22h e o volume de calda de 300 l/ha foi reduzido para 75 e 150l/ha. No primeiro experimento foram aplicadas as doses de 432 g de bentazon/ha e 90 g de lactofen/ha, correspondentes a 60% das recomendações de rótulo desses herbicidas, e no segundo, 60 g lactofen/ha e 157,5 g de fomesafen/ha + 2 % de adjuvante (v/v), correspondentes a 40% e 70% das recomendações. Também foram incluídos nos experimentos tratamentos com as recomendações dos rótulos e testemunhas com e sem capina das plantas daninhas durante todo o ciclo da cultura. As aplicações noturnas, realizadas às 5 e 22h, favoreceram significativamente a ação do lactofen com 60% da dose recomendada e desfavoreceram a do fomesafen no controle das plantas daninhas. Não ocorreram diferenças significativas entre os volumes de aplicação estudados, possibilitando o uso de 75 ou 150 l de calda/ha aplicados nos horários mais favoráveis a cada um dos herbicidas. A maior eficiência das aplicações dos herbicidas bentazon, lactofen e fomesafen depende, além das condições ambientais favoráveis no período noturno, das interações específicas entre os herbicidas e as plantas daninhas.

Comparison of clinical features and drug therapies among European and Latin American patients with juvenile dermatomyositis

ObjectiveTo compare the demographic features, presenting manifestations, diagnostic investigations, disease course, and drug therapies of children with juvenile dermatomyositis (JDM) followed in Europe and Latin America.MethodsPatients were inception cohorts seen between 1980 and 2004 in 27 paediatric rheumatology centres. The following information was collected through the review of patient charts: sex; age at disease onset; date of disease onset and diagnosis; onset type; presenting clinical features; diagnostic investigations; course type; and medications received during disease course.ResultsFour hundred and ninety patients (65.5% females, mean onset age 7.0 years, mean disease duration 7.7 years) were included. Disease presentation was acute or insidious in 57.1% and 42.9% of the patients, respectively. The course type was monophasic in 41.3% of patients and chronic polycyclic or continuous in 58.6% of patients. The more common presenting manifestations were muscle weakness (84.9%), Gottron's papules (72.9%), heliotrope rash (62%), and malar rash (56.7%). Overall, the demographic and clinical features of the 2 continental cohorts were comparable. European patients received more frequently high-dose intravenous methylprednisolone, cyclosporine, cyclophosphamide, and azathioprine, while methotrexate and antimalarials medications were used more commonly by Latin American physicians.ConclusionThe demographic and clinical characteristics of JDM are similar in European and Latin American patients. We found, however, several differences in the use of medications between European and Latin American paediatric rheumatologists.

Autoradiographic investigation of effects of high-dose colchicine on dentinogenesis in rat incisors

Twelve female Wistar rats received 1.5 mg/kg of colchicine (CLC) intravenously. Control animals were similarly injected with isotonic saline solution. The animals were killed 5 h, 24 h, 3 days and 7 days after injection. Ninety minutes prior to sacrifice, all animals received an intraperitoneal injection of 3H-proline. Autoradiograms of maxillary incisors showed that CLC increased the retention of the labeled precursor in the odontoblasts. It was also shown that the odontoblasts in the different sectors of the rat incisor present different sensitivities to the CLC action.

Associacao de opioides lipofilicos a bupivacaina na anestesia peridural. Ha vantagem no aumento da dose do opioide?

Background and Objectives: - The effects of associating lipophilic opioids to local anesthetics in epidural anesthesia are not well defined. There are still questions and controversies about opioid doses to be used and their major effects in the epidural block. This study aimed at evaluating the epidural block effects in humans of the association of different fentanyl and sufentanil doses to bupivacaine with 1:200.000 epinephrine. Methods: - A double-blind randomized study was performed in 94 patients of both genders, physical status ASA I, aged between 18 and 60 years, submitted to lower abdomen, perineal or lower limb surgery. Patients without preanesthetic medication were epidurally injected with 100 mg (20 ml) 0.5% bupivacaine, 0.1 mg (0.1 ml) 1%o epinephrine plus a combination of the following drugs: BUPI Group (15 patients): 2 ml of 0.9% saline solution (SS); FENT50 Group (19 patients): 50 μg (1 ml) fentanyl + 1 ml SS; FENT100 Group (20 patients): 100 μg (2 ml) fentanyl; SUF30 Group (20 patients): 30 μg (0.6 ml) sufentanil + SS (1.4 ml); SUF100 Group (20 patients): 50 μg (1 ml) sufentanil + SS (1 ml). The following parameters were studied: onset of sensory block, analgesic block (onset time) in T12, T10 and T8, analgesic block duration in T10 and T12, motor block degree, consciousness degree, need for supplemental perioperative sedation and analgesia, hypotension, bradycardia and peri and post operative side-effects, analgesia duration, proportion of patients needing supplemental analgesia and evaluation of postoperative pain (pain analog visual scale). Results: Groups were demographically uniform. The addition of fentanyl or sufentanil did not alter major characteristics of perioperative epidural block and has not significantly increased postoperative analgesia duration as compared to the use of bupivacaine only. However, the addition of lipophilic opioids has increased the quality of perioperative anesthetic block, translated into a lesser need for supplemental analgesia (p < 0.02). The increased dose of fentanyl and especially of sufentanil has increased the incidence of perioperative drowsiness (p < 0.001) without significant increase in other side effects. Conclusions: In the conditions and doses used, the addition of lipophilic opioids to bupivacaine and the increased dose of lipophilic opioids have improved anesthetic block quality without changes in the epidural block characteristics or a significant increase in side effects, with the exception of drowsiness mainly caused by sufentanil. However, they were not able to provide a significant increase in postoperative analgesia duration.

Tempo de latencia e duracao do efeito do brometo de rocuronio no paciente submetido ao transplante renal

Background and Objectives - Successful cadaver kidney transplantation relies on a fast procedure. Patients with chronic renal failure may present with a delayed gastric emptying making it critical a fast tracheal intubation and airway maintenance. Rocuronium a recently introduced nondepolarizing neuromuscular blocker with a fast onset. The aim of this study was to evaluate onset time and duration of rocuronium effects in patients undergoing renal transplantation. Methods - Sixty patients were allocated into two groups of 30: Group R (GR) = patients undergoing renal transplantation and Group N (GN) = patients with normal renal function. All patients were premedicated with oral midazolam (15 mg) and anesthesia was induced with 30 μg.kg-1 alfentanil, 0.3 mg.kg-1 etomidate and 0.6 mg.kg-1 rocuronium injected through a central venous catheter. neuromuscular block was monitored by acceleromyography in the ulnar nerve pathway. The following parameters were evaluated: time between administration of rocuronium and first twitch reduction to 5% after supra-maximal stimulation (T1) (onset time = OT); time for first twitch to return to 25% (clinical duration = R25); time elapsed between 25% and 75% recovery of first twitch (relaxation recovery time = R25-75). Heart rate (HR) and mean blood pressure (MBP) were recorded in 6 moments. Results - Median OT was 31 sec. in GR and 47 sec. in GN. Median R25 was 51.5 min in GR and 33.5 min in GN. Median R25-75 was 28 min in GR and 20 min in GN. MBP and HR were higher in GR. Tracheal intubation conditions were excellent for most patients in both groups. Conclusions - These results open the possibility of 0.6 mg.kg-1 rocuronium being injected through a central venous catheter when a faster onset is needed. Due to wide differences in individual responses, monitoring of neuromuscular block is recommended.