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Rocuronium duration of action under sevoflurane, desflurane or propofol anaesthesia

Published online by Cambridge University Press:  28 January 2005

P. G. Maidatsi
Affiliation:
AHEPA University Hospital, Anaesthesiology Department, Thessaloniki, Greece
A. Th. Zaralidou
Affiliation:
AHEPA University Hospital, Anaesthesiology Department, Thessaloniki, Greece
N. K. Gorgias
Affiliation:
‘Saint Demetrios’ General Hospital, Anaesthesiology Department, Thessaloniki, Greece
E. N. Amaniti
Affiliation:
AHEPA University Hospital, Anaesthesiology Department, Thessaloniki, Greece
K. A. Karakoulas
Affiliation:
AHEPA University Hospital, Anaesthesiology Department, Thessaloniki, Greece
M. M. Giala
Affiliation:
AHEPA University Hospital, Anaesthesiology Department, Thessaloniki, Greece
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Summary

Background and objective: We conducted a prospective randomized study to evaluate whether the duration of action of a single bolus dose of rocuronium is influenced by maintenance of anaesthesia with sevoflurane, desflurane or propofol infusion.

Methods: Fifty-seven ASA I–II patients undergoing elective abdominal surgery were enrolled in this study. Anaesthesia was induced with thiopental 3–5 mg kg−1 or propofol 2.5 mg kg−1 and fentanyl 5 μg kg−1 and tracheal intubation was facilitated with rocuronium 0.9 mg kg−1. Thereafter patients were randomly allocated to three different groups to receive sevoflurane, desflurane or propofol for maintenance of anaesthesia. Recovery of neuromuscular function was monitored by single twitch stimulation of the ulnar nerve and by recording the adductor pollicis response using accelerometry. Intergroup recovery times to 5% of control value of single twitch were analysed using analysis of variance with Bonferroni correction.

Results: The mean (95% confidence interval) recovery time to 5% of control value of single twitch during desflurane anaesthesia was 90.18 (86.11–94.25) min. Significantly shorter recovery times were observed during sevoflurane or propofol anaesthesia, 58.86 (54.73–62.99) min and 51.11 (45.47–56.74) min, respectively (P < 0.001). There were also significant differences in the recovery time between groups receiving desflurane vs. sevoflurane (P < 0.001) and desflurane vs. propofol (P < 0.001).

Conclusions: 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.

Type
Original Article
Copyright
© 2004 European Society of Anaesthesiology

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References

Wright PM, Hart P, Lau M, et al. The magnitude and time course of vecuronium by desflurane versus isoflurane. Anesthesiology 1995; 82: 404411.Google Scholar
Wulf H, Hauschild S, Proppe D, Ledowski T. Augmentation of the neuromuscular blocking effect of mivacurium during inhalation anesthesia with desflurane, sevoflurane and isoflurane in comparison with total intravenous anesthesia. Anaesthesiol Reanim 1998; 23: 8892.Google Scholar
Wulf H, Kahl M, Ledowski T. Neuromuscular blocking effects of cisatracurium during desflurane, sevoflurane, isoflurane or total i.v. anaesthesia. Br J Anaesth 1998; 80: 308312.Google Scholar
Bock M, Klippel K, Nitsche B, Bach A, Martin E, Motsch J. Rocuronium potency and recovery characteristics during steady-state desflurane, sevoflurane, isoflurane or propofol anaesthesia. Br J Anaesth 2000; 84: 4347.Google Scholar
Wulf H, Ledowski T, Linstedt U, Proppe D, Sitzlack D. Neuromuscular blocking effects of rocuronium during desflurane, isoflurane and sevoflurane anaesthesia. Can J Anaesth 1998; 45: 526532.Google Scholar
Rampil IJ, Stephen HL, Zwass MS, Peterson N, et al. Clinical characteristics of desflurane in surgical patients: minimum alveolar concentration. Anesthesiology 1991; 74: 429433.Google Scholar
Fragen RJ, Dunn KL. The minimum alveolar concentration (MAC) of sevoflurane with and without nitrous oxide in elderly versus young adults. J Clin Anesth 1996; 8: 352356.Google Scholar
Meretoja OA, Wirtavuori K, Taivainen T, Olkkola KT. Time course of potentiation of mivacurium by halothane and isoflurane in children. Br J Anaesth 1996; 76: 235238.Google Scholar
Ahmed AA, Kumagai M, Otake T, Kurata Y, Amaki Y. Sevoflurane exposure time and the neuromuscular blocking effect of vecuronium. Can J Anaesth 1999; 46: 429432.Google Scholar
Yasuda N, Targ AG, Eger EI. Solubility of I-653, sevoflurane, isoflurane, and halothane in human tissues. Anesth Analg 1989; 69: 370373.Google Scholar
Kumar N, Mirakhur R, Symington MJJ, McCarthy GJ. Potency and time course of action of rocuronium during desflurane and isoflurane anaesthesia. Br J Anaesth 1996; 77: 488491.Google Scholar
Lowry DW, Mirakhur R, McCarthy GJ, Carroll MT, McCourt KC. Neuromuscular effects of rocuronium during sevoflurane, isoflurane and intravenous anesthesia. Anesth Analg 1998; 87: 936940.Google Scholar
Meistelman C, Plaud B, Donati F. Rocuronium (Org 9426) neuromuscular blockade at the adductor muscles of the larynx and adductor pollicis in humans. Can J Anaesth 1992; 39: 665669.Google Scholar
Donati F, Meistelman C, Plaud B. Vecuronium neuromuscular blockade at the adductor muscles of the larynx and adductor pollicis. Anesthesiology 1991; 74: 833837.Google Scholar
Amaniti E, Maidatsi P, Zaralidou A, Giala M. Variations in the duration of action of two aminosteroid neuromuscular blocking agents. Eur J Anaesth 2001; 18 (Suppl 21): A-502 [Abstract].Google Scholar
Van den Broek L, Wierda JMKH, Smeulers NJ, et al. Clinical pharmacology of rocuronium (Org 9426); study on the time course of action, dose requirement, reversibility and pharmacokinetics. J Clin Anesth 1994; 6: 288296.Google Scholar
Dragne A, Varin F, Plaud B, Donati F. Rocuronium pharmacokinetic–pharmacodynamic relationship under stable propofol or isoflurane anesthesia. Can J Anesth 2002; 49: 353360.Google Scholar