Effects of hydrocortisone-presensitized sugammadex on recovery from neuromuscular blockade induced by rocuronium: a rodent in vivo study
- Authors
- Choi, Hey-Ran; Yang, Hong Seuk; Choi, Jae-Moon; Park, Chungon; 인준용; Kim, Yong Beom
- Issue Date
- Apr-2022
- Publisher
- 대한마취통증의학회
- Keywords
- Hydrocortisone; Neuromuscular blockade; Neuromuscular blocking agent; Neuromuscular junction; Rocuronium; Sugammadex.
- Citation
- Anesthesia and Pain Medicine, v.17, no.2, pp.182 - 190
- Journal Title
- Anesthesia and Pain Medicine
- Volume
- 17
- Number
- 2
- Start Page
- 182
- End Page
- 190
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/84192
- DOI
- 10.17085/apm.21076
- ISSN
- 1975-5171
- Abstract
- Background: Sugammadex is a specific antagonist of aminosteroidal neuromuscular blocking agents with 1:1 binding to guest molecules. Sugammadex can also bind to other drugs having a steroid component in its chemical structure. In this in vivo experiment, we investigated the differences in the recovery of rocuronium-induced neuromuscular blockade using sugammadex pre-exposed with two different concentrations of hydrocortisone.Methods: The sciatic nerves and tibialis anterior muscles of 30 adult Sprague–Dawley rats were prepared for the experiment. The sciatic nerves were stimulated using a train-of-four (TOF) pattern with indirect supramaximal stimulation at 20 s intervals. After 15 min of stabilization, a 250 μg loading dose and 125 μg booster doses of rocuronium were serially administered until > 95% depression of the first twitch tension of TOF stimulation (T1) was confirmed. The study drugs were prepared by mixing sugamadex with the same volume of three different stock solutions (0.9% normal saline, 10 mg/ml hydrocortisone, and 100 mg/ml hydrocortisone). The recovery of rats from neuromuscular blockade was monitored by assessing T1 and the TOF ratio (TOFR) simultaneously until T1 was recovered to > 95% and TOFR to > 0.9.Results: In the group injected with sugammadex premixed with a high concentration of hydrocortisone, statistically significant intergroup differences were observed in the recovery progression of T1 and TOFR (P < 0.050).Conclusions: When sugammadex was pre-exposed to a high dose of hydrocortisone only, recovery from neuromuscular blockade was delayed. Delayed recovery from neuromuscular blockade is not always plausible when sugammadex is pre-exposed to steroidal drugs.
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