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Korean J Anesthesiol. 2018 Apr;71(2):113-119. English. Original Article. https://doi.org/10.4097/kjae.2018.71.2.113
Park SY , Kim HJ , Choi YS , Yun SH , Park JC .
Department of Anesthesiology and Pain Medicine, Jeju National University Hospital, Jeju, Korea. pjcook@jejunu.ac.kr
Abstract

Background

The concept of the effect-site concentration of anesthetic agents is important. The effect compartment model can be explained using the concepts of effect-site concentration and effect-site equilibration rate constant (k(e0)). This study confirms that the time-to-peak effect (t(pe)) can be measured easily in clinical practice by applying a priming dose and train-of-four (TOF) during general anesthesia induction, and k(e0) can be calculated from the t(pe) of the four muscle relaxants that are commonly used in general anesthesia.

Methods

Eighty patients who received general anesthesia were divided into the succinylcholine, rocuronium, atracurium, or vecuronium groups. Priming doses of muscle relaxants were administered. The effects of muscle relaxants were quantified by recording the twitch response of the adductor pollicis muscle after stimulating the ulnar nerve. The t(pe) was measured at the lowest TOF value. k(e0) was calculated from the measured t(pe).

Results

The k(e0) values of the succinylcholine, rocuronium, atracurium, and vecuronium groups were 0.076 (0.030)/min, 0.228 (0.122)/min, 0.062 (0.011)/min, and 0.077 (0.019)/min, respectively.

Conclusions

It is possible to estimate k(e0) from the t(pe) of muscle relaxants using a priming dose and TOF during general anesthesia induction.

Copyright © 2019. Korean Association of Medical Journal Editors.