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Neuromuscular Physiology and Pharmacology
Anesthesia and Pain Medicine 2009;4(4):336-340.
Published online October 31, 2009.
Comparison of recovery times from deep neuromuscular blockade between single bolus and continuous infusion of rocuronium
Hong Soon Kim, Kyung Cheon Lee, Dong Chul Lee, Jaehoon Jang, Yong Beom Kim
Department of Anesthesiology and Pain Medicine, Gachon University, Incheon, Korea.
To prevent sudden unexpected movement of patients during surgery, muscle relaxants are used to maintain intense neuromuscular blockade.They are administered by intermittent bolus or continuous infusion.Rocuronium is often used for continuous infusion because it is known to lack cumulative effects. The purpose of this study was to compare recovery times from intense neuromuscular block to reappearance of muscle twitches after 0.1 Hz single twitch stimulation. MATERIALS AND METHODS: Seventy five patients were randomized to one of 3 groups.Patients in group 1 were administered a single bolus of rocuronium; groups 2 and 3 were given continuous infusion of rocuronium for 1 and 2 h, respectively.During anesthesia, neuromuscular blockade was monitored by TOF-watch(R) and regulated so as not to exceed more than 5 (PTC) during the infusion. After infusion, PTC was counted every 5 min until single twitch heights had reappeared and the time till the twitch reappeared was calculated. RESULTS: There was a good correlation between the time it took to observe a PTC and the first response of TOF time in each group.In a parallelism test, there were no significant differences. There were also no significant differences in recovery times from PTC to the reappearance of a single twitch between groups. CONCLUSIONS: There are no significant differences in recovery times-from deep neuromuscular blockade to reappearance of single twitch-regardless of the infusion time.When a PTC occurs during deep neuromuscular blockade, it may predict the remaining time of reappearance of a single twitch response.
Key Words: Cumulation effect, Post-tetanic count, Postoperative residual curarization, Rocuronium, Train-of-four response

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