title: The effect of desflurane on rocuronium onset, clinical duration and maintenance requirements.
abstract: Volatile anesthetics potentiate the effects of non-depolarizing agents. This study investigated the interaction between the inhalational anesthetic desflurane and rocuronium. Forty ASA I and II patients randomly received desflurane/N2O/fentanyl, or propofol/ N2O/fentanyl anesthesia, and rocuronium 0.6 mg/kg. Neuromuscular block was assessed at the adductor pollicis muscle. Block onset and clinical duration times were measured; a rocuronium infusion was started when the first twitch on train-of-four returned to 10% of control (T10%). Maintenance infusion requirements and recovery profiles (spontaneous and after reversal) were recorded until recovery of twitch to 90% of control (T90%). Rocuronium onset was prolonged by 67% (p = 0.034), clinical duration by 30% (p = NS), and infusion requirements were lower in the desflurane group (4.5 vs. 7.1 mg/kg/min, p = 0.003). Recovery times were not statistically different. Desflurane significantly delays the onset of neuromuscular block, potentiates rocuronium during maintenance infusion, but does not affect clinical duration or recovery.
authors.affiliation: Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06520-8051, USA.
authors.forename: R G
authors.initials: RG
authors.lastname: Stout
authors.forename: T J
authors.initials: TJ
authors.lastname: Gan
authors.forename: P S A
authors.initials: PS
authors.lastname: Glass
authors.forename: D G
authors.initials: DG
authors.lastname: Silverman
authors.forename: S J
authors.initials: SJ
authors.lastname: Brull
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000732:Androstanols / Q000494:pharmacology*; D000762:Anesthesia Recovery Period; D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D018686:Anesthetics, Intravenous / Q000009:adverse effects / Q000494:pharmacology; D000077335:Desflurane; D004357:Drug Synergism; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation; D007530:Isoflurane / Q000031:analogs & derivatives* / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D019148:Neuromuscular Blockade; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology*; D015742:Propofol / Q000009:adverse effects / Q000494:pharmacology; D000077123:Rocuronium; D013997:Time Factors
chemical_list: D000732:Androstanols; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D003473:Neuromuscular Nondepolarizing Agents; D000077335:Desflurane; D007530:Isoflurane; D000077123:Rocuronium; D015742:Propofol