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Canadian Journal of Anesthesia, Vol 45, 651-654, Copyright © 1998 by Canadian Anesthesiologists' Society

ARTICLES

Smoking increases the requirement for rocuronium

P Rautoma and N Svartling
Department of Anaesthesia, Toolo Hospital, University of Helsinki, Finland.

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


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F. K. Puhringer, P. Keller, A. Lockinger, A. Kleinsasser, A. Scheller, C. Raedler, and C. Keller
Smoking does not alter the dose-requirements and the pharmacodynamics of rocuronium
Can J Anesth, April 1, 2000; 47(4): 347 - 349.
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Copyright © 1998 by the Canadian Anesthesiologists' Society.