Rocuronium duration of action under sevoflurane, desflurane or propofol anaesthesia

Maidatsi, P.; Zaralidou, A.; Gorgias, N.; Amaniti, Aikaterini; Karakoulas, K.; Giala, M.

doi:10.1017/s0265021504000055

Cited by 10 publications

(10 citation statements)

References 16 publications

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“…Inhalational anesthesia is more commonly used in clinical practice than intravenous anesthesia, so we used an inhalational anesthetic agent for anesthesia maintenance. However, although it remains equivocal [2728], the effect of sevoflurane on the recovery of a neuromuscular blockade by rocuronium cannot be completely ignored. In addition, one report suggested that sugammadex could not be affected by inhalational agents [29].…”

Section: Discussionmentioning

confidence: 99%

Reversal with sugammadex for rocuronium-induced deep neuromuscular block after pretreatment of magnesium sulfate in rabbits

Kang

Kim

Song

2017

Korean J Anesthesiol

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BackgroundMagnesium sulfate (MgSO4) has been used in the treatment of pre-eclampsia, hypertension and arrhythmia. Magnesium enhances the neuromuscular block of rocuronium. This study has been conducted to evaluate the reversal efficacy of sugammadex from deep rocuronium-induced neuromuscular block (NMB) during consistent pretreatment of MgSO4 in rabbits.MethodsTwenty-eight rabbits were randomly assigned to four groups, a control group or study groups (50% MgSO4 150–200 mg/kg and 25 mg/kg/h IV), and received rocuronium 0.6 mg/kg. When post-tetanic count 1–2 appeared, sugammadex 2, 4, and 8 mg/kg was administered in the 2-mg group, control and 4-mg group, and 8-mg group, respectively. The recovery course after reversal of sugammadex administration was evaluated in each group.ResultsThe mean serum concentration of magnesium was maintained at more than 2 mmol/L in the study groups, and the total dose of MgSO4 was more than 590 mg. The reversal effect of sugammadex on rocuronium-induced NMB in pretreated MgSO4 was not different from that in the group without MgSO4. The recovery time to train-of-four ratio 0.9 after sugammadex administration in the 2-mg group was longer than in the other groups (P < 0.001); there were no other significant differences among the groups.ConclusionsThe reversal of sugammadex from a deep rocuronium-induced NMB during large pretreatment of MgSO4 was not affected. However, we should consider that the reversal effect of sugammadex varied depending on the dose.

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Section: Discussionmentioning

confidence: 99%

Reversal with sugammadex for rocuronium-induced deep neuromuscular block after pretreatment of magnesium sulfate in rabbits

Kang

Kim

Song

2017

Korean J Anesthesiol

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“…Because inhalation anesthesia is more widely used than intravenous anesthesia in clinical situations, we used sevoflurane in order to achieve a similar environment. However, sevoflurane delays the recovery from rocuronium compared with intravenous anesthesia [27], and tends to delay it but not significantly [28]. Even though this trial has been implemented in the same environment in each group, sevoflurane may have affected recovery from rocuronium.…”

Section: Discussionmentioning

confidence: 93%

Influence of acute normovolemic hemodilution on the potency and time course of action of rocuronium in rabbits

Lee

Kim

et al. 2016

Anesth Pain Med

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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Background:We performed this study to evaluate the potency and time course of rocuronium-induced neuromuscular block following moderate or severe acute normovolemic hemodilution (ANH) in rabbits. Methods: Forty five rabbits were randomly assigned to the control (C) group, the moderate ANH (M) group, or the severe ANH (S) group. After stabilization of sevoflurane anesthesia, ANH was achieved by drainage of arterial blood and an intravenous infusion of 6% hydroxyethyl starch, during which hematocrit (Hct) decreased to 26.2 ± 2.5% in the M group and 17.6 ± 2.2% in the S group. We determined dose-response relationships of rocuronium in the three groups and created a time course of the action of 0.6 mg/kg rocuronium. Results: The 50% effective dose (ED50) for rocuronium was 45% and 50% lower in the M and S groups, respectively, than in the C group (50.9 ± 6.3 g/kg) (P ＜ 0.001). The onset time after 0.6 mg/kg rocuronium was faster in the ANH groups compared with the C group (P ＜ 0.001). The duration of neuromuscular block was prolonged by 38% and 43% in the M and S groups, respectively, compared with the C group (49.1 ± 6.9 min) (P ＜ 0.001). Conclusions: ANH resulted in high potency, rapid onset, and prolonged duration of rocuronium. However, the severity of ANH did not alter the potency and duration of action of rocuronium.

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“…Desflurane is a relatively new volatile anaesthetic, that have a low blood-gas solubility resulting in rapid uptake and elimination [10]. Its muscle-gas partition coefficient is lower than other volatile anaesthetics [11]. The enhancement of the neuromuscular blocking effects of muscle relaxants (both benzylisoquinoline and aminosteroid) by volatile anaesthetics is well known [11][12][13] and this phenomenon is called as "Potentiation" (10).…”

Section: Discussionmentioning

confidence: 99%

“…Its muscle-gas partition coefficient is lower than other volatile anaesthetics [11]. The enhancement of the neuromuscular blocking effects of muscle relaxants (both benzylisoquinoline and aminosteroid) by volatile anaesthetics is well known [11][12][13] and this phenomenon is called as "Potentiation" (10). Rocuronium bromide is a monoquaternary, aminosteroid, non-depolarising muscle relaxant with rapid onset and intermediate duration of action [10,13].…”

Section: Discussionmentioning

confidence: 99%

Anesthesia for Transoral Endoscopic Parathyroidectomy by Vestibular Approach (TOEPVA)

Yilmaz

Baş

2020

Preprint

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Introduction: After thyroid diseases, hyperparathyroidism is one of the most common endocrine surgical disease. The increasing diagnosis of thyroid pathologies in early stages and a societal emphasis on physical appearances, especially in young women, have been led to development of new surgical techniques alternative to conventional transcervical incision consistently. Here, we describe our anaesthesia experience for parathyroidectomy with Transoral Endoscopic Parathyroidectomy by Vestibular Approach (TOEPVA). Material-method: Patients undergo TOEPVA at the Health Sciences University Izmir Bozyaka Training and Research Hospital between November 2018 and April 2019 were reviewed. Demographic data and hemodynamic parameters were reported. Seven patients were operated successfully by this technique none of which required conversion to conventional open surgery. Two patient required atropine and one patient required ephedrine during insufflation. Conclusion: After induction of anaesthesia with propofol, remifentanil and rocuronium; anaesthesia managed by desflurane co-administered with continous infusion of remifentanil, provide feasible and safe anaesthesia for TOEPVA. However, especially during hydrodissection and insufflation, a close cooperation between surgeon and anaesthetist have a great value to improve patient management.

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Rocuronium duration of action under sevoflurane, desflurane or propofol anaesthesia

Abstract: Desflurane anaesthesia significantly prolongs the duration of action of rocuronium at 0.9 mg kg(-1) single bolus dose, compared to sevoflurane or propofol anaesthesia maintenance regimens.

Cited by 10 publications

References 16 publications

Reversal with sugammadex for rocuronium-induced deep neuromuscular block after pretreatment of magnesium sulfate in rabbits

Reversal with sugammadex for rocuronium-induced deep neuromuscular block after pretreatment of magnesium sulfate in rabbits

Influence of acute normovolemic hemodilution on the potency and time course of action of rocuronium in rabbits

Anesthesia for Transoral Endoscopic Parathyroidectomy by Vestibular Approach (TOEPVA)

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