Anesthesia-Related Pharmacology and Toxicology
Reversibility of rocuronium-induced profound neuromuscular block with sugammadex in younger and older patients
Suzuki T, Kitajima O, Ueda K, et al (Nihon Univ School of Medicine, Tokyo, Japan) Br J Anaesth 106:823-826, 2011§
Evidence Ranking
• A
Expert Rating
• 2
Abstract
Background
This study compared the reversibility of rocuronium-induced profound neuromuscular block with sugammadex in younger and older patients.
Methods
Fifteen younger (20–50 yr) and 15 older (≥70 yr) patients were sequentially enrolled in this study. After induction of anaesthesia and laryngeal mask insertion, contraction of the adductor pollicis muscle in response to ulnar nerve stimulation was quantified using acceleromyography during 1.0–1.5% end-tidal sevoflurane and remifentanil anaesthesia. All patients initially received rocuronium 1 mg kg−1, followed by 0.02 mg kg−1 when a post-tetanic count (PTC) of 1 or 2 was observed. After completion of surgery, at reappearance of 1–2 PTC, the time required for a single bolus dose of 4 mg kg−1 sugammadex to produce recovery to a train-of-four (TOF) ratio of 0.9 was recorded.
Results
There were no differences in the total dose of rocuronium administered between the younger [mean (sd): 93.4 (17.5) mg] and the older [97.5 (32.2) mg] groups. In all patients, adequate recovery of the TOF ratio to 0.9 was achieved after administration of sugammadex, although it was significantly slower in the older [3.6 (0.7) min, P < 0.0001] than in the younger group [1.3 (0.3) min]. There were no clinical events attributable to recurarization.
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