title: [Characteristics of neuromuscular block after administration of rocuronium bromide in patients with end-stage renal failure].
abstract: BACKGROUND
  Anaesthesia affects kidney function by reducing the renal blood flow and glomerular filtration rate. As chronic renal failure (CRF) significantly influences drug metabolism and elimination, we studied the effects of rocuronium bromide (RB) in patients with CRF.
  
  
  OBJECTIVE
  The aim of the study was to examine whether, when using RB in patients with CFR, there are differences regarding the onset time of neuromuscular block (NMB) development, duration time, speed of recovery and cumulative effects of RB.
  
  
  METHODS
  Prospective study included 60 patients who underwent urologic surgery procedures. The patients were divided into 3 groups: the first group (G1)--20 patients with CRF and residual dieresis, the second group (G2)--20 patients with CRF and without dieresis, and third group (G3)--20 patients with normal renal function (control group). During surgery RB was administrated for muscle paralysis in all patients. Train-of-four (TOF) Guard acceleromyography was used for NMB monitoring.
  
  
  RESULTS
  Onset time in three groups was 132.3 s; 139.5 s and 113.2 s (p < 0.01). Duration of intubation dose was the same in G1 and G2 (28.9 minutes), while in the third group it was 27.2 minutes (p > 0.05).The number of RB repeated doses was 3-8, 3-7 and 4-8 (p > 0.05). The duration time until spontaneous recovery was 31.8, 31.6 and 29.8 minutes (p > 0.01). The recovery index was 16.8,16.7 and 10.6 minutes (p < 0.001). The duration time from the last dose of RB to extubation was 74.5, 74.8 and 58.9 minutes (p < 0.001).
  
  
  CONCLUSIONS
  In patients with CRF the cumulative effect of the drug was registered, with a prolonged recovery time from NMB in relation to the patients with normal renal function.
authors.forename: Nevena
authors.initials: N
authors.lastname: Kalezić
authors.forename: Biljana
authors.initials: B
authors.lastname: Krivić
authors.forename: Vladan
authors.initials: V
authors.lastname: Živaljević
authors.forename: Djordje
authors.initials: D
authors.lastname: Ugrinović
authors.forename: Dijana
authors.initials: D
authors.lastname: Jovanović
authors.forename: Dejan
authors.initials: D
authors.lastname: Marković
authors.forename: Jelena
authors.initials: J
authors.lastname: Veličković
authors.forename: Nebojša
authors.initials: N
authors.lastname: Ladjević
mesh_terms: D000293:Adolescent; D000328:Adult; D000732:Androstanols / Q000008:administration & dosage*; D000758:Anesthesia; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology*; D008297:Male; D016343:Monitoring, Intraoperative; D019148:Neuromuscular Blockade; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage*; D000077123:Rocuronium; D055815:Young Adult
chemical_list: D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D000077123:Rocuronium