Korean J Anesthesiol.  2009 Nov;57(5):566-571. 10.4097/kjae.2009.57.5.566.

Time course of neuromuscular effects of rocuronium during desflurane anesthesia in patients with or without renal failure

• Kim KS
• Yeon JT
• Lee HJ

• KMID: 2092241
• DOI: http://doi.org/10.4097/kjae.2009.57.5.566

Abstract

BACKGROUND
This study aimed to investigate the neuromuscular effects of 0.6 mg/kg rocuronium under desflurane anesthesia in patients with and without renal failure.
METHODS
The neuromuscular effects of rocuronium 0.6 mg/kg under desflurane anesthesia were investigated in 20 patients with renal failure undergoing renal transplantation surgery and in 20 patients with normal renal function. Neuromuscular transmission was monitored using acceleromyography with single stimuli at 0.1 Hz. The onset and 25%, 75%, and 95% twitch recovery times, the recovery of the train-of-four ratio to 70% (TOF70), and the recovery index (25-75%) were recorded.
RESULTS
Block onset was similar in the groups. The 25%, 75% and 95% twitch recovery times, the TOF70 time, and the recovery index were found to be prolonged in patients with renal failure compared to those with normal renal function (e.g. TOF70: 123.1 +/- 49.1 vs. 68.7 +/- 15.5 min) (P<0.001). A very strong association between the time to TOF70 and the diagnostic duration of renal failure was found (R2 = 0.79, P<0.001).
CONCLUSIONS
The duration of action of a bolus dose of 0.6 mg/kg rocuronium under desflurane anesthesia was increased significantly in patients with end-stage renal failure compared to that of healthy controls and was prolonged according to the duration of renal failure.

Keyword

Chronic renal failure; Desflurane; Rocuronium

MeSH Terms

Androstanols
Anesthesia
Humans
Isoflurane
Kidney Failure, Chronic
Kidney Transplantation
Neuromuscular Agents
Renal Insufficiency
Androstanols
Isoflurane
Neuromuscular Agents