<abstract xmlns="http://www.w3.org/1999/xhtml"> Background: Respiratory function can be impaired during general anesthesia involving neuromuscular blockers such as rocuronium. However, the magnitude of the problems and the efficacy of their reversal with antagonistic drugs are not known.Objective: To investigate the effects of arterial carbon dioxide (PaCO2) on recovery from rocuronium-induced neuromusuclar blockade with or without antagonism by neostigmine.Methods: Ninety patients were randomly divided into six groups; group I and A, normal PaCO2 (35-45mmHg), group II and B, low PaCO2 (30-35mmHg), group III and C, high PaCO2 (45-50mmHg). The extent of neuromuscular blockade was evaluated by train-of-four (TOF) -watch accelerograph. Anesthesia was induced with intravenous propofol, fentanyl, and rocuronium 0.6mg/kg. Additional injection of rocuronium 0.15mg/kg per time was given whenever the first twitch of TOF (T1) recovered to 25%. The residual neuromuscular blockade was antagonized with neostigmine 0.02mg/kg in the groups I, II and III, when T1 reached 25%. The duration from T1 25% to 75% was recorded and defined as the recovery index and that from T1 25% to TOFR 0.9 was the recovery time.Results: Both the recovery index and recovery time in group II were much shorter than in group I (p &lt;0.05), while much longer in group III than in group I (p &lt;0.05). No significant differences were found for the comparisons of those of values between groups B and A, or between groups C and A, although they were longer in group C than in group B. A linear relationship was found between the recovery index or recovery time and PaCO2.Conclusion: Elevated PaCO2 prolongs the spontaneous recovery of neuromuscular blockade induced by rocuronium, as well as recovery after small doses of neostigmine, with a linear relationship.</abstract>

Background: Respiratory function can be impaired during general anesthesia involving neuromuscular blockers such as rocuronium. However, the magnitude of the problems and the efficacy of their reversal with antagonistic drugs are not known.Objective: To investigate the effects of arterial carbon dioxide (PaCO2) on recovery from rocuronium-induced neuromusuclar blockade with or without antagonism by neostigmine.Methods: Ninety patients were randomly divided into six groups; group I and A, normal PaCO2 (35-45mmHg), group II and B, low PaCO2 (30-35mmHg), group III and C, high PaCO2 (45-50mmHg). The extent of neuromuscular blockade was evaluated by train-of-four (TOF) -watch accelerograph. Anesthesia was induced with intravenous propofol, fentanyl, and rocuronium 0.6mg/kg. Additional injection of rocuronium 0.15mg/kg per time was given whenever the first twitch of TOF (T1) recovered to 25%. The residual neuromuscular blockade was antagonized with neostigmine 0.02mg/kg in the groups I, II and III, when T1 reached 25%. The duration from T1 25% to 75% was recorded and defined as the recovery index and that from T1 25% to TOFR 0.9 was the recovery time.Results: Both the recovery index and recovery time in group II were much shorter than in group I (p <0.05), while much longer in group III than in group I (p <0.05). No significant differences were found for the comparisons of those of values between groups B and A, or between groups C and A, although they were longer in group C than in group B. A linear relationship was found between the recovery index or recovery time and PaCO2.Conclusion: Elevated PaCO2 prolongs the spontaneous recovery of neuromuscular blockade induced by rocuronium, as well as recovery after small doses of neostigmine, with a linear relationship.

Effects of arterial carbon dioxide on recovery from rocuronium-induced neuromuscular blockade in anesthetized patients

Department of Anesthesiology, Affiliated First People’s Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai 200080,

MD, PhD, Department of Anesthesiology, Affiliated First People’s Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai 200080,

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Background: Respiratory function can be impaired during general anesthesia involving neuromuscular blockers such as rocuronium. However, the magnitude of the...

Effects of arterial carbon dioxide on recovery from rocuronium-induced neuromuscular blockade in anesthetized patients

Article Category: Original article

Published Online: Feb 04, 2017

Page range: 73 - 79

DOI: https://doi.org/10.5372/1905-7415.0701.152

Keywords
Neuromuscular blockade, PaCO2, recovery, rocuronium

© 2017

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Effects of arterial carbon dioxide on recovery from rocuronium-induced neuromuscular blockade in anesthetized patients

Article Category: Original article

Published Online: Feb 04, 2017

Page range: 73 - 79

DOI: https://doi.org/10.5372/1905-7415.0701.152

KeywordsNeuromuscular blockade, PaCO2, recovery, rocuronium

© 2017

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
Neuromuscular blockade, PaCO2, recovery, rocuronium