Effects of different sugammadex doses on the train of four ratio recovery progression during rocuronium induced neuromuscular blockade in the rat phrenic nerve hemidiaphragm
김용범, 최재문, 장연진, 최혜란, 인준용, 양홍석,
소속 상세정보
김용범 ( Kim Yong-Beom ) - Gachon University Gil Medical Center Department of Anesthesiology and Pain Medicine
최재문 ( Choi Jae-Moon ) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
장연진 ( Chang Young-Jin ) - Gachon University Gil Medical Center Department of Anesthesiology and Pain Medicine
최혜란 ( Choi Hey-Ran ) - Inje University College of Medicine Seoul Paik Hospital Department of Anesthesiology and Pain Medicine
인준용 ( In Jun-Yong ) - Dongguk University Ilsan Hospital Department of Anesthesiology and Pain Medicine
양홍석 ( Yang Hong-Seuk ) - Daejon Sun Hospital Department of Anaesthesiology and Pain Medicine
Abstract
Background: In this study, we used an ex-vivo model to investigate the recovery pattern of both the train-of-four (TOF) ratio and first twitch tension of TOF (T1), and determined their relationship during recovery from rocuronium-induced neuromuscular blockade at various concentrations of sugammadex.
Methods: Tissue specimens of the phrenic nerve-hemidiaphragm were obtained from 60 adult Sprague-Dawley rats. Each specimen was immersed in an organ bath filled with Krebs buffer solution and stimulated with the TOF pattern using indirect supramaximal stimulation at 20-second intervals. After a 30-minute stabilization period, rocuronium loading and booster doses were serially administered at 10-minute intervals in each sample until > 95% depression of T1 was confirmed. Specimens were randomly allocated to either the control group (washout) or to one of five sugammadex concentration groups (0.75, 1, 2, 4, or 8 times equimolar doses of rocuronium to produce > 95% T1 depressions; SGX0.75, SGX1, SGX2, SGX4, and SGX8, respectively). Recovery from neuromuscular blockade was monitored using T1 and the TOF ratio simultaneously until the recovery of T1 to > 95% and the TOF ratio to > 0.9.
Results: Statistically significant intergroup differences were observed between the recovery patterns of T1 and the TOF ratio (TOFR, P < 0.050), except between SGX2 and SGX4 groups. TOFR/T1 values were maintained at nearly 1 in the control, SGX0.75, and SGX1 groups; however, they were exponentially decayed in the SGX2, SGX4, and SGX8 groups.
Conclusions: Recovery of the TOF ratio may be influenced by the sugammadex dose, and a TOF ratio of 1.0 may be achieved before full T1 recovery if administration of sugammadex exceeds that of rocuronium.
키워드
Acetylcholine; Neuromuscular blockade; Neuromuscular blocking agent; Neuromuscular physiology; Rocuronium; Sugammadex
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