• P Szmuk, T Ezri, J E Chelly, and J Katz.
• Department of Anesthesiology, University of Texas Medical School at Houston, 77030, USA. pszmuk@anes1.med.uth.tmc.edu
• Anesth. Analg. 2000 May 1;90(5):1217-9.

AbstractAdministration of ephedrine prior to rocuronium decreases the onset time of neuromuscular blockade from rocuronium by 26%. This effect was attributed to a increased cardiac output. If so, beta adrenergic-blocking drugs, which decrease cardiac output, should prolong the onset time of rocuronium. In a double-blind study, 60 patients were randomly assigned to three groups (n = 20) to receive either 70 microg. kg(-1) of ephedrine, 0.5 mg. kg(-1) esmolol or placebo, 30 s before induction of anesthesia. Onset time of rocuronium was defined as the time from the end of its injection to disappearance of all four twitches of the train-of-four. The onset time of rocuronium was significantly shorter after ephedrine (22%) and longer after esmolol (26%), as compared to placebo. No differences were observed among the three groups with regard to heart rate, systolic, diastolic or mean blood pressure. We concluded that a dose of 0.5 mg. kg(-1) of esmolol significantly prolongs the onset time of rocuronium with minimal hemodynamic changes.

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