Smoking increases the requirement for rocuronium |
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Authors: | P Rautoma N Svartling |
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Institution: | 1. Department of Anaesthesia, T??l? Hospital, University of Helsinki, Helsinki, Finland
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Abstract: | Purpose To compare the potency of rocuronium in non-smokers and smokers during general anaesthesia. Methods 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. Results The ED95 values (± SEM) for rocuronium were 460.5 ± 28.9 and 471.5 ± 22.1 μg·kg?1 for nonsmokers 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 μg·kg?1·hr?1 for non-smokers and smokers, respectively (P = 0.0504). Conclusion The results may indicate increased metabolism of rocuronium in smokers rather than increased requirement of rocuronium at the receptor site. |
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