European journal of anaesthesiology · 2018
Dexamethasone concentration affecting rocuronium-induced neuromuscular blockade and sugammadex reversal in a rat phrenic nerve-hemidiaphragm model: An ex vivo study.
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In Junyong, Bae Hansu, Choi Heyran, Kim Yong Beom, Lee Sangseok, Yang Hong Seuk
Аннотация
BACKGROUND: The concentration range of dexamethasone that inhibits neuromuscular blockade (NMB) and sugammadex reversal remains unclear.
OBJECTIVE: To evaluate the effects of dexamethasone on rocuronium-induced NMB and sugammadex reversal.
DESIGN: Ex vivo study.
SETTING: Asan Institute for Life Sciences, Asan Medical Center, Korea, from July 2015 to November 2015.
ANIMALS: One hundred sixty male Sprague-Dawley rats.
INTERVENTIONS: We assessed the effect of four concentrations of dexamethasone [0, 0.5, 5 (clinical concentrations) and 50 μg ml (experimental concentration)] on partial NMB on 40 phrenic nerve-hemidiaphragm preparations (n=10 per concentration). Once the first twitch of train-of-four (TOF) had been depressed by 50% with rocuronium, dexamethasone was administered. To assess the effect of dexamethasone on sugammadex reversal, 120 phrenic nerve-hemidiaphragm preparations were used in three subexperiments (n=40 per experiment), using three administration regimens of rocuronium-equimolar sugammadex: a single dose, a split-dose (split and ) and a reduced split-dose (split and ). After complete NMB was achieved, dexamethasone and sugammadex were administered.
MAIN OUTCOME MEASURES: The change in the first twitch height, the recovery time to a TOF ratio at least 0.9, and the TOF ratio at 30 min were evaluated.
RESULTS: There were no significant differences in the first twitch height among groups (P = 0.532). With a single dose of sugammadex, dexamethasone did not affect the recovery time to a TOF ratio at least 0.9 (P = 0.070). After using a split-dose of sugammadex, the recovery time to a TOF ratio at least 0.9 was delayed only at a concentration of 50 μg ml of dexamethasone. With a reduced split-dose of sugammadex, the TOF ratio at 30 min was lowered only by a concentration of 50 μg ml of dexamethasone (P < 0.010).
CONCLUSION: Acute bolus administration of dexamethasone at clinical concentrations had no effect on NMB or on sugammadex reversal.
OBJECTIVE: To evaluate the effects of dexamethasone on rocuronium-induced NMB and sugammadex reversal.
DESIGN: Ex vivo study.
SETTING: Asan Institute for Life Sciences, Asan Medical Center, Korea, from July 2015 to November 2015.
ANIMALS: One hundred sixty male Sprague-Dawley rats.
INTERVENTIONS: We assessed the effect of four concentrations of dexamethasone [0, 0.5, 5 (clinical concentrations) and 50 μg ml (experimental concentration)] on partial NMB on 40 phrenic nerve-hemidiaphragm preparations (n=10 per concentration). Once the first twitch of train-of-four (TOF) had been depressed by 50% with rocuronium, dexamethasone was administered. To assess the effect of dexamethasone on sugammadex reversal, 120 phrenic nerve-hemidiaphragm preparations were used in three subexperiments (n=40 per experiment), using three administration regimens of rocuronium-equimolar sugammadex: a single dose, a split-dose (split and ) and a reduced split-dose (split and ). After complete NMB was achieved, dexamethasone and sugammadex were administered.
MAIN OUTCOME MEASURES: The change in the first twitch height, the recovery time to a TOF ratio at least 0.9, and the TOF ratio at 30 min were evaluated.
RESULTS: There were no significant differences in the first twitch height among groups (P = 0.532). With a single dose of sugammadex, dexamethasone did not affect the recovery time to a TOF ratio at least 0.9 (P = 0.070). After using a split-dose of sugammadex, the recovery time to a TOF ratio at least 0.9 was delayed only at a concentration of 50 μg ml of dexamethasone. With a reduced split-dose of sugammadex, the TOF ratio at 30 min was lowered only by a concentration of 50 μg ml of dexamethasone (P < 0.010).
CONCLUSION: Acute bolus administration of dexamethasone at clinical concentrations had no effect on NMB or on sugammadex reversal.
Предметные рубрики MeSH
AnimalsAntiemeticsDelayed Emergence from AnesthesiaDexamethasoneDiaphragmDisease Models, AnimalDose-Response Relationship, DrugDrug InteractionsHumansMaleNeuromuscular BlockadeNeuromuscular MonitoringNeuromuscular Nondepolarizing AgentsPhrenic NervePostoperative Nausea and VomitingRatsRats, Sprague-DawleyRocuroniumSugammadexTime Factors