title: The neuromuscular effects of rocuronium under sevoflurane-remifentanil or propofol-remifentanil anesthesia: a randomized clinical comparative study in an Asian population.
abstract: We conducted a prospective, randomized, multicenter study to evaluate the differences in the blocking effect of different doses of rocuronium between sevoflurane- or propofol-remifentanil anesthesia in an Asian population.
  
  
  
  A total of 368 ASA I-II patients was enrolled. Anesthesia was induced with 2.0 mg/kg propofol and 0.1 μg/kg/min remifentanil (TIVA) or 5.0 vol.% sevoflurane with 0.1 μg/kg/min remifentanil (SEVO). Tracheal intubation was facilitated at 180 s after the administration of rocuronium at 0.3, 0.6, or 0.9 mg/kg and then intubation condition was evaluated. The time to maximum block and recovery profile were monitored by TOF stimulation of the ulnar nerve and by recording the adductor pollicis response using acceleromyography.
  
  
  
  The numbers of patients with clinically acceptable intubation conditions were 41, 82, and 97 % (TIVA) and 34, 85, and 90 % (SEVO) at each dose of rocuronium, respectively. There were no significant differences in the time to maximum block between groups at each rocuronium dose. There were significant differences in the recovery to a train-of-four ratio of 90 % between the groups: 42.7 (19.5), 74.8 (29.9), and 118.4 (35.1) min (TIVA) and 66.5 (39.3), 110.2 (43.5), and 144.4 (57.5) min (SEVO) at 0.3, 0.6, and 0.9 mg/kg, respectively (P < 0.001).
  
  
  
  There are no significant differences in intubation conditions between propofol-remifentanil and sevoflurane-remifentanil anesthesia at the same dose of rocuronium. The type of anesthetic does not significantly influence the time to maximum block by rocuronium. Rocuronium at a dose of 0.9 mg/kg should be used for better intubation conditions with both anesthesia regimens in an Asian population.
  
  
  
  UMIN-CTR Clinical Trial ( http://www.umin.ac.jp/ctr/index.htm ; UMIN#000007289 ; date of registration 14(th) February 2012).
authors.affiliation: Department of Anesthesiology and Pain Medicine, Sanggye Paik Hospital, In-Je University, College of Medicine, Seoul, South Korea.
authors.forename: Sangseok
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul Asan Medical Center, University of Ulsan, College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Ro
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul Asan Medical Center, University of Ulsan, College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea.
authors.forename: Won Uk
authors.initials: WU
authors.lastname: Koh
authors.affiliation: Department of Anesthesiology, Shinagawa Shishokai Hospital, Tokyo, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Nishiyama
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul Asan Medical Center, University of Ulsan, College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea. hsyang@amc.seoul.kr.
authors.forename: Hong-Seuk
authors.initials: HS
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D000732:Androstanols / Q000008:administration & dosage*; D019162:Anesthetics, Combined / Q000008:administration & dosage; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D044466:Asian People; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage*; D008875:Middle Aged; D019148:Neuromuscular Blockade / Q000379:methods; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage; D010880:Piperidines / Q000008:administration & dosage*; D015742:Propofol / Q000008:administration & dosage*; D011446:Prospective Studies; D000077208:Remifentanil; D000077123:Rocuronium; D000077149:Sevoflurane; D016037:Single-Blind Method
chemical_list: D000732:Androstanols; D019162:Anesthetics, Combined; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D003473:Neuromuscular Nondepolarizing Agents; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil; D000077123:Rocuronium; D015742:Propofol
keywords: Anesthetics inhalation; Anesthetics intravenous; Duration of action; Intubation condition; Monitoring; Neuromuscular blocking agents; Onset; Propofol; Remifentanil; Rocuronium; Sevoflurane