• Stefan Soltész, Patrick Fraisl, Karl Günter Noé, Jochen Hinkelbein, Hermann Mellinghoff, and Thomas Mencke.
• 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).
• Eur J Anaesthesiol. 2014 Aug 1;31(8):417-22.

BackgroundSeveral drugs influence the time course of neuromuscular block during general anaesthesia.ObjectiveTo evaluate the effect of a single dose of dexamethasone 8 mg on the time course of a rocuronium-induced neuromuscular block.DesignA randomised controlled, unblinded, monocentre trial.SettingKreiskrankenhaus Dormagen, Dormagen, Germany.PatientsOne hundred and eight adult patients scheduled for elective gynaecological laparoscopic surgery allocated to three groups.InterventionsPatients 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).Main Outcome MeasuresThe 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.ResultsThe 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).ConclusionA 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.Trial RegistrationClinicalTrial.gov Identifier: NCT01782820.

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