Korean J Anesthesiol.  2018 Dec;71(6):476-482. 10.4097/kja.d.17.00011.

Effects of adenosine receptor agonist on the rocuronium-induced neuromuscular block and sugammadex-induced recovery

• Kim YB
• Lee S
• Choi HR
• In J
• Chang YJ
• Kim HJ
• Ro YJ
• Yang HS

• KMID: 2428080
• DOI: http://doi.org/10.4097/kja.d.17.00011

Abstract

BACKGROUND
Several types of receptors are found at neuromuscular presynaptic membranes. Presynaptic inhibitory A1 and facilitatory A2A receptors mediate different modulatory functions on acetylcholine release. This study investigated whether adenosine A1 receptor agonist contributes to the first twitch tension (T1) of train-of-four (TOF) stimulation depression and TOF fade during rocuronium-induced neuromuscular blockade, and sugammadex-induced recovery.
METHODS
Phrenic nerve-diaphragm tissues were obtained from 30 adult Sprague-Dawley rats. Each tissue specimen was randomly allocated to either control group or 2-chloroadenosine (CADO, 10 μM) group. One hour of reaction time was allowed before initiating main experimental data collection. Loading and boost doses of rocuronium were sequentially administered until > 95% depression of the T1 was achieved. After confirming that there was no T1 twitch tension response, 15 min of resting time was allowed, after which sugammadex was administered. Recovery profiles (T1, TOF ratio [TOFR], and recovery index) were collected for 1 h and compared between groups.
RESULTS
There were statistically significant differences on amount of rocuronium (actually used during experiment), TOFR changes during concentration-response of rocuronium (P = 0.04), and recovery profiles (P < 0.01) of CADO group comparing with the control group. However, at the initial phase of this experiment, dose-response of rocuronium in each group demonstrated no statistically significant differences (P = 0.12).
CONCLUSIONS
The adenosine A1 receptor agonist (CADO) influenced the TOFR and the recovery profile. After activating adenosine receptor, sugammadex-induced recovery from rocuronium-induced neuromuscular block was delayed.

Keyword

Adenosine A₁-receptor; Neuromuscular junction; Neuromuscular nondepolarizing agents; Rocuronium; Sugammadex

MeSH Terms

2-Chloroadenosine
Acetylcholine
Adenosine*
Adult
Data Collection
Depression
Humans
Membranes
Neuromuscular Blockade*
Neuromuscular Junction
Neuromuscular Nondepolarizing Agents
Rats, Sprague-Dawley
Reaction Time
Receptor, Adenosine A1
Receptors, Purinergic P1*
2-Chloroadenosine
Acetylcholine
Adenosine
Neuromuscular Nondepolarizing Agents
Receptor, Adenosine A1
Receptors, Purinergic P1