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Use of rocuronium for endotracheal intubation of North American Gulf Coast box turtles

Gretchen E. KaufmanDepartment of Environmental and Population Health, School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.

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Rosemarie E. SeymourDepartment of Clinical Sciences, School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.
Present address is the Jackson Laboratory, 600 Main St, Bar Harbor, ME 04609-1500.

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Barbara B. BonnerTurtle Hospital of New England, 1 Grafton Rd, Upton, MA 01568.

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Michael H. CourtDepartment of Pharmacology and Experimental Therapeutics, School of Medicine, Tufts University, Boston, MA 02111.

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Alicia Z. KarasDepartment of Clinical Sciences, School of Veterinary Medicine, Tufts University, North Grafton, MA 01536.

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Abstract

Objective—To determine whether rocuronium, a reversible neuromuscular blocking agent, would provide safe, short-term immobilization to facilitate endotracheal intubation in turtles.

Design—Prospective study.

Animals—30 healthy adult Gulf Coast box turtles.

Procedure—Turtles were given rocuronium, and responses were recorded every 3 minutes. Times to onset of effects, intubation, and recovery were recorded and analyzed for associations with dose and patient characteristics to determine an optimal dose range. Neostigmine and glycopyrrolate were given to augment recovery from neuromuscular blockade.

Results—Rocuronium administered at a dose of 0.25 to 0.5 mg/kg (0.11 to 0.23 mg/lb), IM, permitted intubation; lower doses were not effective. Mean ± SD time to loss of the palpebral reflex was 6.4 ± 4.0 minutes, and mean time to intubation was 9.2 ± 6.4 minutes. Mean time to return of the palpebral reflex was 44 ± 13.2 minutes, and mean time to walking was 55 ± 16.6 minutes. Time to onset of effects was not associated with dose, but recovery times were prolonged with higher doses of rocuronium. Cardiac arrhythmias were observed in 13 (43%) turtles.

Conclusions and Clinical Relevance—Administration of rocuronium at a dose of 0.25 to 0.5 mg/kg is a safe and effective adjunct to general anesthesia in Gulf Coast box turtles. Because rocuronium does not provide any analgesic or sedative effects, the duration of neuromuscular blockade without anesthesia should be minimized to avoid undue distress. (J Am Vet Med Assoc 2003;222:1111–1115)

Abstract

Objective—To determine whether rocuronium, a reversible neuromuscular blocking agent, would provide safe, short-term immobilization to facilitate endotracheal intubation in turtles.

Design—Prospective study.

Animals—30 healthy adult Gulf Coast box turtles.

Procedure—Turtles were given rocuronium, and responses were recorded every 3 minutes. Times to onset of effects, intubation, and recovery were recorded and analyzed for associations with dose and patient characteristics to determine an optimal dose range. Neostigmine and glycopyrrolate were given to augment recovery from neuromuscular blockade.

Results—Rocuronium administered at a dose of 0.25 to 0.5 mg/kg (0.11 to 0.23 mg/lb), IM, permitted intubation; lower doses were not effective. Mean ± SD time to loss of the palpebral reflex was 6.4 ± 4.0 minutes, and mean time to intubation was 9.2 ± 6.4 minutes. Mean time to return of the palpebral reflex was 44 ± 13.2 minutes, and mean time to walking was 55 ± 16.6 minutes. Time to onset of effects was not associated with dose, but recovery times were prolonged with higher doses of rocuronium. Cardiac arrhythmias were observed in 13 (43%) turtles.

Conclusions and Clinical Relevance—Administration of rocuronium at a dose of 0.25 to 0.5 mg/kg is a safe and effective adjunct to general anesthesia in Gulf Coast box turtles. Because rocuronium does not provide any analgesic or sedative effects, the duration of neuromuscular blockade without anesthesia should be minimized to avoid undue distress. (J Am Vet Med Assoc 2003;222:1111–1115)