Dexamethasone concentration affecting rocuronium-induced neuromuscular blockade and sugammadex reversal in a rat phrenic nerve-hemidiaphragm model

Abstract

Acute bolus administration of dexamethasone at clinical concentrations had no effect on NMB or on sugammadex reversal.

Effect of protracted dexamethasone exposure and its withdrawal on rocuronium-induced neuromuscular blockade and sugammadex reversal: an ex vivo rat study

“…Only a few in vitro or ex vivo studies exist regarding the interaction of rocuronium and sugammadex 29–33 ; thus, there is no consensus on the recommended dose of sugammadex to be used in an ex vivo study. Previously, we have used an equimolar dose of sugammadex and rocuronium 30,33 ; this was based on the mechanism of action of sugammadex which encapsulates the free rocuronium molecules in 1: 1 molecular ratio 34 . However, in a clinical setting, a 0.6 mg kg −1 dose of rocuronium is routinely used, and 4 mg kg −1 dose of sugammadex is recommended by the manufacturer’s guideline when no twitch response on a TOF (and post-tetanic count ≥ 1) is seen.…”

Impact of intravenous dexamethasone on the initiation and recovery of atracurium in children: A double‐blinded randomized controlled trial

“…The application of intravenous perioperative methylprednisolone can also reduce the period of action of neuromuscular blockers 10 . Several trials on phrenic nerve‐diaphragm preparations in rats have also shown that dexamethasone curtails the period of action of neuromuscular blockers 11,12 …”

“…10 Several trials on phrenic nerve-diaphragm preparations in rats have also shown that dexamethasone curtails the period of action of neuromuscular blockers. 11,12 The interest in a potential interaction of dexamethasone with neuromuscular blockade primarily came up after the introduction of sugammadex into clinical practice as it possesses a similar steroidal ring-like rocuronium with an initial in vitro 13 study. Soltész et al 14 were the first to demonstrate that a single dose of intravenous dexamethasone can attenuate the duration of action of rocuronium.…”