Effects of methylprednisolone on the duration of rocuronium-induced neuromuscular block

Abstract

Background:We aim to investigate whether intraoperative use of methylprednisolone could affect the duration of rocuronium-induced neuromuscular blockade.Methods:A double blind, randomized, placebo-controlled trial was conducted. A total of 136 patients underwent gynecologic laparoscopic surgery were randomly divided into 3 groups: pregroup, receiving intravenous injection of methylprednisolone (40 mg) 30 minutes before induction of anesthesia; postgroup, receiving intravenous injection of methylprednisolone (40 mg) immediately after induction of anesthesia and intubation; and control group, receiving intravenous injection of normal saline. Patients were intravenously administrated with rocuronium 0.6 mg/kg, and changes in adductor policies evoked twitch responses were measured by ulnar nerve stimulator.Results:We found that all patients achieved maximum blockade effects, and there was no difference in onset time among the 2 groups. For time required to achieve train-of-four ratio (TOFR) 90%, pregroup (64.50 ± 10.52 minutes) and postgroup (65.29 ± 11.64 minutes) were significantly shorter than that of the control group (71.04 ± 10.55 minutes, P = .027), whereas clinical duration and total duration were significantly shorter in the 2 groups received methylprednisolone than the control group. However, there was no significant difference between the 2 treatment groups either in clinical duration and total duration of muscle relaxants, or time required to achieve TOFR 90%. No significant difference was found in recovery index among the 3 groups.Conclusion:Our findings suggest that a single intravenous injection of methylprednisolone, no matter preoperatively or intraoperatively, could shorten the duration of rocuronium-induced neuromuscular blockade.

Influence of methylprednisolone on the reversal time of sugammadex: a randomized clinical trial

“… 36 However, a recent paper by Geng et al demonstrated that methylprednisolone (40 mg), no matter preoperatively or intra-operatively, could shorten the duration of rocuronium-induced neuromuscular blockade. 37 According to these findings, the effect of rocuronium in our study should have been diminished in the methylprednisolone administered group. On the contrary, our findings indicated that the recovery time was longer in this group.…”

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

“…Previously chronic steroid intake has been associated with a reduction in the duration of neuromuscular block 9 . 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 …”

“…9 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 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.…”