Smoking increases the requirement for rocuronium

To compare the potency of rocuronium in non-smokers and smokers during general anaesthesia. In a randomized, open clinical study, 40 patients, 17-62 yr of age, were anaesthetized with propofol, alfentanil and nitrous oxide in oxygen. After obtaining individual dose-response curves for rocuronium, bo...

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Bibliographic Details
Published in:Canadian journal of anesthesia 1998-07, Vol.45 (7), p.651-654
Main Authors: RAUTOMA, P, SVARTLING, N
Format: Article
Language:English
Subjects:
Adolescent
Adult
Androstanols - administration & dosage
Anesthesia, General
Anesthetics. Neuromuscular blocking agents
Biological and medical sciences
Dose-Response Relationship, Drug
Female
Humans
Male
Medical sciences
Middle Aged
Neuromuscular Nondepolarizing Agents - administration & dosage
Neuropharmacology
Pharmacology. Drug treatments
Smoking - physiopathology
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Summary:To compare the potency of rocuronium in non-smokers and smokers during general anaesthesia. In a randomized, open clinical study, 40 patients, 17-62 yr of age, were anaesthetized with propofol, alfentanil and nitrous oxide in oxygen. After obtaining individual dose-response curves for rocuronium, bolus doses of rocuronium were given to maintain neuromuscular block at 90-99% for 60 min. Evoked adductor pollicis electromyography (EMG) was used to monitor neuromuscular block. The ED95 values (+/- SEM) for rocuronium were 460.5 +/- 28.9 and 471.5 +/- 22.1 micrograms.kg-1 for non-smokers and smokers, respectively (P:NS). However, doses of rocuronium to maintain 90-99% neuromuscular block (+/- SEM) were 620.1 +/- 46.7 and 747.4 +/- 56.0 micrograms.kg-1.hr-1 for non-smokers and smokers, respectively (P = 0.0504). The results may indicate increased metabolism of rocuronium in smokers rather than increased requirement of rocuronium at the receptor site.
ISSN:0832-610X
1496-8975
DOI:10.1007/BF03012095