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Rapacuronium (RAP) is a new aminosteroid, nondepolarizing neuromuscular blocking agent undergoing evaluation in clinical trials. It has an onset time of 1 to 2 minutes and a clinical duration of less than 20 minutes. This randomized trial from Canada investigated the reversibility of RAP in 117 healthy elective anesthesia patients. The study was partly funded by industry.
After induction of anesthesia with fentanyl, propofol infusion, and nitrous oxide, patients received 1.5 or 2.5 mg/kg of RAP and were intubated 60 seconds later. They then were given neostigmine at 0.05 or 0.07 mg/kg (with 0.01 mg/kg glycopyrrolate) or no reversal agent either 2 or 5 minutes after RAP. Complete neuromuscular block occurred within a mean of 50 seconds with b…