Reversal of rocuronium-induced neuromuscular block with sugammadex and resulting histopathological effects in rat kidneys.
BACKGROUND
This study investigated the effect of injection of rocuronium or sugammadex alone and rocuronium + sugammadex on urea, creatinine, electrolyte levels, and histopathological findings in rats.


METHODS
Thirty-six Sprague-Dawley male rats were divided to receive intravenously 16 or 96 mg/kg sugammadex, 1 mg/kg rocuronium, 1 mg/kg rocuronium + 16 mg/kg sugammadex, or 1 mg/kg rocuronium + 96 mg/kg sugammadex. The control group received an equal volume of physiological serum. Rats receiving rocuronium were ventilated until resumption of spontaneous ventilation and followed for 72 h. Blood samples were withdrawn from the tail vein to measure urea, creatinine, and electrolyte values; then both kidneys were excised, and the tissues were used for histopathological examination.


RESULTS
Rats receiving rocuronium and high doses of sugammadex (96 mg/kg) showed increased glomerular vacuolation, tubular dilatation, vascular vacuolation and hypertrophy, lymphocyte infiltration, and tubular cell sloughing compared to the control group (p = 0.002). Biochemical markers of renal function were not significantly altered after treatment with high doses of sugammadex.


CONCLUSIONS
The elimination half-life of the rocuronium-sugammadex complex was found to be greater than that of free rocuronium or sugammadex, which led to marginal histopathological changes in the kidney without affecting any renal functions.
Department of Anesthesiology and Intensive Care, Medical Faculty, Rize University, Rize, Turkey. habib.bostan@rize.edu.tr
Habib
H
Bostan
Yıldıray
Y
Kalkan
Yakup
Y
Tomak
Levent
L
Tumkaya
Durdu
D
Altuner
Adnan
A
Yılmaz
Baar
B
Erdivanli
Recep
R
Bedir
D000732:Androstanols / Q000008:administration & dosage / Q000494:pharmacology*; D000818:Animals; D007668:Kidney / Q000187:drug effects* / Q000473:pathology*; D008297:Male; D019148:Neuromuscular Blockade; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage / Q000494:pharmacology*; D051381:Rats; D017207:Rats, Sprague-Dawley; D000077123:Rocuronium; D000077122:Sugammadex; D047408:gamma-Cyclodextrins / Q000008:administration & dosage / Q000494:pharmacology*
D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D000077123:Rocuronium