title: Dexamethasone decreases the duration of rocuronium-induced neuromuscular block: a randomised controlled study.
abstract: BACKGROUND
  Several drugs influence the time course of neuromuscular block during general anaesthesia.
  
  
  OBJECTIVE
  To evaluate the effect of a single dose of dexamethasone 8 mg on the time course of a rocuronium-induced neuromuscular block.
  
  
  METHODS
  A randomised controlled, unblinded, monocentre trial.
  
  
  METHODS
  Kreiskrankenhaus Dormagen, Dormagen, Germany.
  
  
  METHODS
  One hundred and eight adult patients scheduled for elective gynaecological laparoscopic surgery allocated to three groups.
  
  
  METHODS
  Patients received dexamethasone 8 mg intravenously 2 to 3 h prior to surgery (Group A), during induction of anaesthesia (Group B) or after recovery of the neuromuscular block (Group C, control).
  
  
  METHODS
  The time course of the neuromuscular block of rocuronium 0.3 mg kg was assessed using acceleromyography. The primary end point was the time from start of injection of rocuronium until recovery to a train-of-four ratio of 0.9.
  
  
  RESULTS
  The clinical duration was decreased in Group A (15.8 ± 4.5 min) compared with Group B (18.7 ± 5.8 min; P = 0.031). The recovery index was reduced in Group A (6.8 ± 1.8 min) compared with Group B (8.1 ± 2.6 min; P = 0.018) and Group C (8.3 ± 2.8 min; P = 0.01). The recovery to a train-of-four ratio of 0.9 was shorter in Group A (30.4 ± 6.9 min) than in Groups B (36.3 ± 10.7 min; P = 0.031) and C (36.8 ± 11.3 min; P = 0.02).
  
  
  CONCLUSIONS
  A single dose of dexamethasone 8 mg attenuated rocuronium-induced block by 15 to 20% if administered 2 to 3 h prior to induction of anaesthesia. However, the administration of dexamethasone during induction of anaesthesia did not influence the time course of the neuromuscular block.
  
  
  BACKGROUND
  ClinicalTrial.gov Identifier: NCT01782820.
authors.affiliation: From the Department of Anaesthesia and Intensive Care (SS, PF) and the Department of Gynaecology (KGN), KKH Dormagen, Dormagen, the Department of Anaesthesia and Intensive Care, University of Cologne, Cologne (JH, HM) and the Department of Anaesthesia and Intensive Care Medicine, University of Rostock, Rostock, Germany (TM).
authors.forename: Stefan
authors.initials: S
authors.lastname: Soltész
authors.forename: Patrick
authors.initials: P
authors.lastname: Fraisl
authors.forename: Karl Günter
authors.initials: KG
authors.lastname: Noé
authors.forename: Jochen
authors.initials: J
authors.lastname: Hinkelbein
authors.forename: Hermann
authors.initials: H
authors.lastname: Mellinghoff
authors.forename: Thomas
authors.initials: T
authors.lastname: Mencke
mesh_terms: D000328:Adult; D000732:Androstanols; D000762:Anesthesia Recovery Period; D003907:Dexamethasone; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D019148:Neuromuscular Blockade / Q000379:methods*; D003473:Neuromuscular Nondepolarizing Agents; D011446:Prospective Studies; D000077123:Rocuronium; D009435:Synaptic Transmission / Q000187:drug effects
chemical_list: D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D003907:Dexamethasone; D000077123:Rocuronium