Pharmacokinetics of rocuronium after bolus and continuous infusion during halothane anaesthesia

• Published in: British journal of anaesthesia : BJA Vol. 76; no. 1; pp. 29 - 33
• Main Authors: McCoy, E P, Mirakhur, R K, Maddineni, V R, Wierda, J M, Proost, J H
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.01.1996; Oxford University Press; Oxford Publishing Limited (England)
• Subjects: Adolescent; Adult; Androstanols - administration & dosage; Androstanols - pharmacokinetics; Androstanols - pharmacology; Anesthesia, Inhalation; Anesthetics, Inhalation; Anesthetics. Neuromuscular blocking agents; Biological and medical sciences; Female; Halothane; Humans; Infusions, Intravenous; Male; Medical sciences; Middle Aged; Muscle Contraction - drug effects; Neuromuscular Junction - drug effects; Neuromuscular Nondepolarizing Agents - administration & dosage; Neuromuscular Nondepolarizing Agents - pharmacokinetics; Neuromuscular Nondepolarizing Agents - pharmacology; Neuropharmacology; Pharmacology. Drug treatments; Rocuronium; Volatile compound; Human; Pharmacokinetic pharmacodynamic relationship; Non depolarisant myorelaxant; General anesthetic; General anesthesia; Pharmacokinetics; Neuromuscular blocking
• ISSN: 0007-0912; 1471-6771
• DOI: 10.1093/bja/76.1.29

We have studied the pharmacokinetics of a single bolus of rocuronium (Org 9426), followed by an infusion, in eight patients during anaesthesia with halothane and nitrous oxide in oxygen. Neuromuscular block was monitored using train-of-four (TOF) stimulation and recording the force of contraction of the adductor pollicis muscle. Rocuronium was administered as an initial bolus dose of 0.45 mg kg-1 followed by an infusion adjusted manually to maintain T1 (first response in the TOF) at 10% of control. Mean onset time and time to recovery of T1 to 10% were 72 (SD 19.6) s and 27 (9.6) min, respectively. The infusion rates were stable in 19.8 (6.5) min. The mean requirement for rocuronium for steady state 90% block of T1 was 528 (163.3) micrograms kg-1 h-1. After cessation of surgery the infusion was stopped and patients were allowed to recover spontaneously. The times to attain a T1 of 90% and a TOF ratio of 0.7 were 31 (11.7) min and 36 (7.3) min, respectively. Blood samples were collected for 390 min after cessation of infusion and concentrations of rocuronium and its putative metabolites measured using HPLC. A two-exponential equation was used to describe the pharmacokinetic data. The rate of clearance, mean residence time and volume of distribution at steady state were 3.3 (0.77) ml kg-1 min-1, 67.2 (18.8) min and 212.5 (40.1) ml kg-1, respectively. The distribution (T1/2 alpha) and elimination (T1/2 beta) half-lives were 7.5 (3.33) min and 85.6 (18.4) min, respectively. These values were not significantly different from previously published data for a single bolus dose of rocuronium.