Duration of rocuronium action directly correlates with BMI.

pearl

• Osamu Takahata, Ken-Ichi Takahoko, Tomoki Sasakawa, Yasuyoshi Inagaki, Hiroyuki Takahoko, and Takayuki Kunisawa.
• From the Department of Pain Clinic, Asahikawa-Kosei General Hospital, Asahikawa (OT), Department of Anesthesiology, National Hospital Organization Obihiro Hospital, Obihiro (K-iT), Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical University, Asahikawa (TS,TK), Emergency Medical Center, Nayoro City General Hospital, Nayoro (YI) and Department of Anesthesiology, Engaru-Kosei General Hospital, Engaru, Japan (HT).
• Eur J Anaesthesiol. 2018 Nov 1; 35 (11): 863-866.

BackgroundThe duration of rocuronium in patients with BMI more than 30 kg m is prolonged. Whether the reverse is true when BMI is less than 18.5 kg m is unclear.ObjectiveThe objective of this study was to investigate whether a BMI less than 25 kg m affects the duration of rocuronium in doses adjusted for actual body weight.DesignA prospective, observational, single-centre study.SettingThe operating room of a teaching hospital from 1 June 2008 to 30 June 2015.PatientsThirty patients with American Society of Anesthesiologists physical status I or II who were scheduled to undergo elective surgery (BMI < 25 kg m, aged 23 to 74 years) maintained by 0.7 minimum alveolar concentration sevoflurane and remifentanil.Main Outcome MeasuresRepetitive train-of-four stimulation was applied and contractions of the adductor pollicis muscle were recorded. Duration of the initial dose of rocuronium (D1) was defined as the time from injection of rocuronium 0.6 mg kg to return of first twitch height to 25% of the control. Duration of additional doses (D2) was the time from a supplement of 0.15 mg kg rocuronium to return of first twitch height to 25% of the control. The relationship between D1 or D2 and BMI was examined using linear regression analysis.ResultsLinear regression analysis revealed a significant correlation between duration of initial dose and BMI (R = 0.246; P = 0.00531). A significant correlation between the duration of the additional dose and BMI was also found (R = 0.316; P = 0.00122).ConclusionThe lower the BMI, the shorter the duration of rocuronium at initial and additional doses determined by the actual body weight in adult patients with a BMI less than 25 kg m.Trial Registrationwww.umin.ac.jp/ctr/index/htm with registry number UMIN 00009337 and UMIN 000015407.

This article appears in the collection: Neuromuscular myths: the lies we tell ourselves.

20 keywords...

hide…