Concentration of rocuronium in cerebrospinal fluid of patients undergoing cerebral aneurysm clipping.
BACKGROUND
This study assessed the concentration of rocuronium in the cerebrospinal fluid (CSF) of patients undergoing cerebral aneurysm clipping, and investigated whether the mode of administration (single bolus vs continuous infusion) influenced the CSF concentration.


METHODS
Twenty patients with subarachnoid haemorrhage were randomly allocated to receive a bolus dose (bolus group), or a bolus followed by a continuous infusion of rocuronium (infusion group) (n=10 for each group). Arterial blood and ventricular CSF were sampled 2 h after the rocuronium bolus. Samples were analysed by liquid chromatography electrospray ionization-tandem mass spectrometry.


RESULTS
Rocuronium could be detected in all the CSF samples. The mean (range) CSF concentration was 2.2 (0.9-4.6) ng x ml(-1) in the bolus group and 12.4 (2.4-34.6) ng x ml(-1) in the infusion group; P<0.01.


CONCLUSIONS
This study demonstrated that rocuronium, normally not considered to cross the blood-brain barrier, is regularly found in the CSF of patients undergoing cerebral clipping; continuous infusion of the drug led to higher plasma and CSF concentrations than after a single bolus dose.
Fuchs-Buder
T
T
Department of Anaesthesia and Critical Care, University of Saarland, Homburg/Saar, Germany. t.fuchs-buder@chu-nancy.fr
Strowitzki
M
M
Rentsch
K
K
Schreiber
J U
JU
Philipp-Osterman
S
S
Kleinschmidt
S
S
D000328:Adult; D000732:Androstanols / Q000008:administration & dosage / Q000097:blood / Q000134:cerebrospinal fluid*; D001812:Blood-Brain Barrier; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000097:blood / Q000134:cerebrospinal fluid / Q000601:surgery*; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage / Q000097:blood / Q000134:cerebrospinal fluid*; D000077123:Rocuronium
D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D000077123:Rocuronium