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The neuromuscular effects of rocuronium under sevoflurane-remifentanil or propofol-remifentanil anesthesia: a randomized clinical comparative study in an Asian population.
BMC Anesthesiol. 2016 08 22; 16(1):65.BA

Abstract

BACKGROUND

We conducted a prospective, randomized, multicenter study to evaluate the differences in the blocking effect of different doses of rocuronium between sevoflurane- or propofol-remifentanil anesthesia in an Asian population.

METHODS

A total of 368 ASA I-II patients was enrolled. Anesthesia was induced with 2.0 mg/kg propofol and 0.1 μg/kg/min remifentanil (TIVA) or 5.0 vol.% sevoflurane with 0.1 μg/kg/min remifentanil (SEVO). Tracheal intubation was facilitated at 180 s after the administration of rocuronium at 0.3, 0.6, or 0.9 mg/kg and then intubation condition was evaluated. The time to maximum block and recovery profile were monitored by TOF stimulation of the ulnar nerve and by recording the adductor pollicis response using acceleromyography.

RESULTS

The numbers of patients with clinically acceptable intubation conditions were 41, 82, and 97 % (TIVA) and 34, 85, and 90 % (SEVO) at each dose of rocuronium, respectively. There were no significant differences in the time to maximum block between groups at each rocuronium dose. There were significant differences in the recovery to a train-of-four ratio of 90 % between the groups: 42.7 (19.5), 74.8 (29.9), and 118.4 (35.1) min (TIVA) and 66.5 (39.3), 110.2 (43.5), and 144.4 (57.5) min (SEVO) at 0.3, 0.6, and 0.9 mg/kg, respectively (P < 0.001).

CONCLUSIONS

There are no significant differences in intubation conditions between propofol-remifentanil and sevoflurane-remifentanil anesthesia at the same dose of rocuronium. The type of anesthetic does not significantly influence the time to maximum block by rocuronium. Rocuronium at a dose of 0.9 mg/kg should be used for better intubation conditions with both anesthesia regimens in an Asian population.

TRIAL REGISTRATION

UMIN-CTR Clinical Trial (http://www.umin.ac.jp/ctr/index.htm ; UMIN#000007289 ; date of registration 14(th) February 2012).

Authors+Show Affiliations

Department of Anesthesiology and Pain Medicine, Sanggye Paik Hospital, In-Je University, College of Medicine, Seoul, South Korea.Department of Anesthesiology and Pain Medicine, Seoul Asan Medical Center, University of Ulsan, College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea.Department of Anesthesiology and Pain Medicine, Seoul Asan Medical Center, University of Ulsan, College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea.Department of Anesthesiology, Shinagawa Shishokai Hospital, Tokyo, Japan.Department of Anesthesiology and Pain Medicine, Seoul Asan Medical Center, University of Ulsan, College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea. hsyang@amc.seoul.kr.

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

27549387

Citation

Lee, Sangseok, et al. "The Neuromuscular Effects of Rocuronium Under Sevoflurane-remifentanil or Propofol-remifentanil Anesthesia: a Randomized Clinical Comparative Study in an Asian Population." BMC Anesthesiology, vol. 16, no. 1, 2016, p. 65.
Lee S, Ro YJ, Koh WU, et al. The neuromuscular effects of rocuronium under sevoflurane-remifentanil or propofol-remifentanil anesthesia: a randomized clinical comparative study in an Asian population. BMC Anesthesiol. 2016;16(1):65.
Lee, S., Ro, Y. J., Koh, W. U., Nishiyama, T., & Yang, H. S. (2016). The neuromuscular effects of rocuronium under sevoflurane-remifentanil or propofol-remifentanil anesthesia: a randomized clinical comparative study in an Asian population. BMC Anesthesiology, 16(1), 65. https://doi.org/10.1186/s12871-016-0231-0
Lee S, et al. The Neuromuscular Effects of Rocuronium Under Sevoflurane-remifentanil or Propofol-remifentanil Anesthesia: a Randomized Clinical Comparative Study in an Asian Population. BMC Anesthesiol. 2016 08 22;16(1):65. PubMed PMID: 27549387.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The neuromuscular effects of rocuronium under sevoflurane-remifentanil or propofol-remifentanil anesthesia: a randomized clinical comparative study in an Asian population. AU - Lee,Sangseok, AU - Ro,Young Jin, AU - Koh,Won Uk, AU - Nishiyama,Tomoki, AU - Yang,Hong-Seuk, Y1 - 2016/08/22/ PY - 2015/08/06/received PY - 2016/08/18/accepted PY - 2016/8/24/entrez PY - 2016/8/24/pubmed PY - 2017/8/5/medline KW - Anesthetics inhalation KW - Anesthetics intravenous KW - Duration of action KW - Intubation condition KW - Monitoring KW - Neuromuscular blocking agents KW - Onset KW - Propofol KW - Remifentanil KW - Rocuronium KW - Sevoflurane SP - 65 EP - 65 JF - BMC anesthesiology JO - BMC Anesthesiol VL - 16 IS - 1 N2 - BACKGROUND: We conducted a prospective, randomized, multicenter study to evaluate the differences in the blocking effect of different doses of rocuronium between sevoflurane- or propofol-remifentanil anesthesia in an Asian population. METHODS: A total of 368 ASA I-II patients was enrolled. Anesthesia was induced with 2.0 mg/kg propofol and 0.1 μg/kg/min remifentanil (TIVA) or 5.0 vol.% sevoflurane with 0.1 μg/kg/min remifentanil (SEVO). Tracheal intubation was facilitated at 180 s after the administration of rocuronium at 0.3, 0.6, or 0.9 mg/kg and then intubation condition was evaluated. The time to maximum block and recovery profile were monitored by TOF stimulation of the ulnar nerve and by recording the adductor pollicis response using acceleromyography. RESULTS: The numbers of patients with clinically acceptable intubation conditions were 41, 82, and 97 % (TIVA) and 34, 85, and 90 % (SEVO) at each dose of rocuronium, respectively. There were no significant differences in the time to maximum block between groups at each rocuronium dose. There were significant differences in the recovery to a train-of-four ratio of 90 % between the groups: 42.7 (19.5), 74.8 (29.9), and 118.4 (35.1) min (TIVA) and 66.5 (39.3), 110.2 (43.5), and 144.4 (57.5) min (SEVO) at 0.3, 0.6, and 0.9 mg/kg, respectively (P < 0.001). CONCLUSIONS: There are no significant differences in intubation conditions between propofol-remifentanil and sevoflurane-remifentanil anesthesia at the same dose of rocuronium. The type of anesthetic does not significantly influence the time to maximum block by rocuronium. Rocuronium at a dose of 0.9 mg/kg should be used for better intubation conditions with both anesthesia regimens in an Asian population. TRIAL REGISTRATION: UMIN-CTR Clinical Trial (http://www.umin.ac.jp/ctr/index.htm ; UMIN#000007289 ; date of registration 14(th) February 2012). SN - 1471-2253 UR - https://www.unboundmedicine.com/medline/citation/27549387/The_neuromuscular_effects_of_rocuronium_under_sevoflurane_remifentanil_or_propofol_remifentanil_anesthesia:_a_randomized_clinical_comparative_study_in_an_Asian_population_ L2 - https://bmcanesthesiol.biomedcentral.com/articles/10.1186/s12871-016-0231-0 DB - PRIME DP - Unbound Medicine ER -