Rocuronium Bromide Inhibits Inflammation and Pain by Suppressing Nitric Oxide Production and Enhancing Prostaglandin E₂ Synthesis in Endothelial Cells

Abstract

PurposeRocuronium bromide is a nondepolarizing neuromuscular blocking drug and has been used as an adjunct for relaxation or paralysis of the skeletal muscles, facilitation of endotracheal intubation, and improving surgical conditions during general anesthesia. However, intravenous injection of rocuronium bromide induces injection pain or withdrawal movement. The exact mechanism of rocuronium bromide-induced injection pain or withdrawal movement is not yet understood. We investigated whether rocuronium bromide treatment is involved in the induction of inflammation and pain in vascular endothelial cells.MethodsFor this study, calf pulmonary artery endothelial (CPAE) cells were used, and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, Western blot, nitric oxide detection, and prostaglandin E2 immunoassay were conducted.ResultsRocuronium bromide treatment inhibited endothelial nitric oxide synthase and suppressed nitric oxide production in CPAE cells. Rocuronium bromide activated cyclooxygenase-2, inducible nitric oxide synthase and increased prostaglandin E2 synthesis in CPAE cells.ConclusionsRocuronium bromide induced inflammation and pain in CPAE cells. Suppressing nitric oxide production and enhancing prostaglandin E2 synthesis might be associated with rocuronium bromide-induced injection pain or withdrawal movement.

Diosgenin improves functional recovery from sciatic crushed nerve injury in rats

“… Alba et al (2006) demonstrated that iNOS expression was overexpressed under pain conditions, and iNOS inhibitors exerted anti-inflammatory effect. Therefore, expressions of COX-2 and iNOS are closely associated with the pathogenesis of inflammatory and neuropathic pain ( Baek et al, 2016 ). In the present study, COX-2 and iNOS expressions were increased by sciatic crushed nerve injury, indicating that injury to the sciatic nerve induced inflammation.…”

“…Western blot analysis for BDNF, TrkB, COX-2, iNOS were performed according to the previous method ( Baek et al, 2016 ; Park et al, 2017 ). Sciatic nerve tissue samples were homogenized in the lysis buffer and 200 μg the samples were centrifuged at 14,000 rpm at 20 min and supernatant collected for Western blot.…”

“…Nitric oxide (NO) is a messenger and effecter molecule in a variety of tissues ( Lowenstein and Greenberg, 1996 ). NO was identified as a neurotransmitter, and it acts as a potent vasodilator in physiological condition ( Baek et al, 2016 ). The production of NO is regulation by intracellular nitric oxide synthases (NOS), and three types of NOS have been identified: endothelial nitric oxide synthase (eNOS), neural nitric oxide synthase (nNOS), and inducible nitric oxide synthase (iNOS).…”

Effects of muscle relaxants on ischaemia damage in skeletal muscle

“…Though the low potency of rocuronium to act as an antagonist on M 2 and M 3 receptors 23 makes it unlikely that clinically relevant effects may be observed, we cannot exclude that our results could have been influenced not only by the action of rocuronium on the muscle cell membrane, but also by extra-junctional receptor interaction. Furthermore has an influence of rocuronium on nitric oxide production been described 24 . The findings of this study by Baek et al .…”

Neurourological Application of Neurogenesis and Inflammation and Pain Mechanisms of Rocuronium Bromide

“…One is “Current opinion on the role of neurogenesis in the therapeutic strategies for Alzheimer disease, Parkinson disease, and ischemic stroke; considering neuronal voiding function” [1] and the other is “Rocuronium bromide inhibits inflammation and pain by suppressing nitric oxide production and enhancing prostaglandin E2 synthesis in endothelial cells” [2]. …”