• H J Lee, K S Kim, J T Yeon, J K Suh, I H Sung, and I C Shin.
• Department of Anesthesiology and Pain Medicine, Hanyang University Hospital, Haengdang dong, Sungdong gu, Seoul, Korea.
• Anaesthesia. 2010 Sep 1; 65 (9): 899-903.

AbstractSodium bicarbonate may be added to rocuronium to decrease pain on injection. However, this mixture may result in the formation of carbon dioxide bubbles. We investigated whether the addition of sodium bicarbonate to rocuronium alters neuromuscular blockade, in 120 patients randomly assigned to receive rocuronium mixed with saline or bicarbonate 8.4%, either in varying doses (for dose-response measurements; 60 patients) or a fixed dose of 600 μg.kg(-1) (for time-course measurements; 60 patients). Sodium bicarbonate resulted in a left-shift of the rocuronium dose-response curve. The effective doses of rocuronium to produce 95% twitch depression were 331.6 (95% CI: 310.4-352.8) and 284.3 (95% CI: 262.0-306.6) μg.kg(-1) mixed with isotonic saline or sodium bicarbonate, respectively (p < 0.001). The mean (SD) onset times of rocuronium 600 μg.kg(-1) were 3.6 (0.6) and 2.7 (0.5) min in the corresponding groups, respectively (p < 0.001). The mean (SD) times to 95% recovery were 35.8 (5.8) and 47.9 (7.1) min, respectively (p < 0.001). We conclude that the mixing of sodium bicarbonate with rocuronium enhances the potency, shortens the onset and prolongs the duration of action.© 2010 The Authors. Journal compilation © 2010 The Association of Anaesthetists of Great Britain and Ireland.

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