Smoking increases the requirement for rocuronium

• Published in: Canadian journal of anesthesia Vol. 45; no. 7; pp. 651 - 654
• Main Authors: RAUTOMA, P, SVARTLING, N
• Format: Journal Article
• Language: English
• Published: Toronto, ON Canadian Anesthesiologists' Society 01.07.1998; Springer Nature B.V
• Subjects: Adolescent; Adult; Androstanols - administration & dosage; Anesthesia, General; Anesthetics. Neuromuscular blocking agents; Biological and medical sciences; Dose-Response Relationship, Drug; Female; Humans; Male; Medical sciences; Middle Aged; Neuromuscular Nondepolarizing Agents - administration & dosage; Neuropharmacology; Pharmacology. Drug treatments; Smoking - physiopathology; Human; Steroid; Tobacco; Non depolarisant myorelaxant; Rocuronium bromide; General anesthesia; Neuromuscular blocking; Dose activity relation
• ISSN: 0832-610X; 1496-8975
• DOI: 10.1007/BF03012095

To compare the potency of rocuronium in non-smokers and smokers during general anaesthesia. In 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. The 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). The results may indicate increased metabolism of rocuronium in smokers rather than increased requirement of rocuronium at the receptor site.