title: Correlation between cardiac output and reversibility of rocuronium-induced moderate neuromuscular block with sugammadex.
abstract: BACKGROUND
  The aim of this study was to evaluate the correlation between cardiac output (CO) and reversibility of rocuronium-induced moderate neuromuscular block with sugammadex in elderly patients.
  
  
  METHODS
  Fifty elderly (≥ 65 years) patients were enrolled in this study. During 1.0-1.5% end-tidal sevoflurane and remifentanil anaesthesia, contraction of the adductor pollicis muscle in response to ulnar nerve stimulation was acceleromyographically quantified. All patients initially received 1 mg/kg rocuronium followed by 0.2 mg/kg whenever the second twitch T2 of the train-of-four (TOF) response reappeared. CO was measured throughout the study using a FloTrac™/Vigileo™ monitor. After completion of surgery and at the reappearance of T2, the time required for a bolus dose of 2 mg/kg sugammadex to facilitate recovery to a TOF ratio of 0.9 was recorded, and its correlation with CO was analysed.
  
  
  RESULTS
  Adequate recovery of neuromuscular block was achieved after sugammadex in all patients. Mean CO at the time of reversal with sugammadex was 5.3 l/min (1.3), and recovery time to a TOF ratio of 0.9 was 173.4 s (54.8). A statistically significant inverse correlation was seen between the time to recovery to a TOF ratio of 0.9 and CO [reversal time (s) = -27.7·CO + 298.7, R(2)  = 0.461, P < 0.0001].
  
  
  CONCLUSIONS
  The time to reach a TOF ratio of 0.9 following sugammadex is dependent on CO in elderly patients.
authors: Department of Cardiology, Saiseikai Kawaguchi General Hospital, Japan.
authors: F
authors: F
authors: Yoshida
authors: T
authors: T
authors: Suzuki
authors: A
authors: A
authors: Kashiwai
authors: T
authors: T
authors: Furuya
authors: J
authors: J
authors: Konishi
authors: S
authors: S
authors: Ogawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000732:Androstanols / Q000008:administration & dosage / Q000037:antagonists & inhibitors*; D000758:Anesthesia; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General; D002302:Cardiac Output / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative; D019148:Neuromuscular Blockade; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage / Q000037:antagonists & inhibitors*; D000077123:Rocuronium; D000077122:Sugammadex; D014459:Ulnar Nerve / Q000187:drug effects / Q000502:physiology; D047408:gamma-Cyclodextrins / Q000494:pharmacology*
chemical_list: D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D047408:gamma-Cyclodextrins; D000077122:Sugammadex; D000077123:Rocuronium