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Randomized Controlled Trial Comparative Study Clinical Trial
Smoking increases the requirement for rocuronium.
- P Rautoma and N Svartling.
- Department of Anaesthesia, Töölö Hospital, University of Helsinki, Finland.
- Can J Anaesth. 1998 Jul 1;45(7):651-4.
PurposeTo compare the potency of rocuronium in non-smokers and smokers during general anaesthesia.MethodsIn a randomized, open clinical study, 40 patients, 17-62 yr of age, were anaesthetized with propofol, alfentanil and nitrous oxide in oxygen. After obtaining individual dose-response curves for rocuronium, bolus doses of rocuronium were given to maintain neuromuscular block at 90-99% for 60 min. Evoked adductor pollicis electromyography (EMG) was used to monitor neuromuscular block.ResultsThe ED95 values (+/- SEM) for rocuronium were 460.5 +/- 28.9 and 471.5 +/- 22.1 micrograms.kg-1 for non-smokers and smokers, respectively (P:NS). However, doses of rocuronium to maintain 90-99% neuromuscular block (+/- SEM) were 620.1 +/- 46.7 and 747.4 +/- 56.0 micrograms.kg-1.hr-1 for non-smokers and smokers, respectively (P = 0.0504).ConclusionThe results may indicate increased metabolism of rocuronium in smokers rather than increased requirement of rocuronium at the receptor site.
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