Rocuronium action can be affected by hyperventilation: a case report and computational simulation.
J Clin Monit Comput
; 37(4): 1115-1118, 2023 08.
Article
en En
| MEDLINE
| ID: mdl-37138040
ABSTRACT
The neuromuscular blocking potency of rocuronium varies with respiratory pH changes, increasing at lower pH and decreasing at higher pH; thus, hyperventilation-induced respiratory alkalosis is expected to decrease the potency of rocuronium. We report a case of anesthetic management of modified electroconvulsive therapy (m-ECT) for a patient monitored with electromyography-based neuromuscular monitoring during two patterns of ventilation to elucidate their relationship and propose the possible mechanisms underlying the effects by computational simulations. Case presentation The patient was a 25-year-old man with schizophrenia. In m-ECT, hyperventilation may be used to produce longer seizures. We compared the neuromuscular monitoring data recorded during hyperventilation and during normal ventilation while receiving the same dose of rocuronium. Despite receiving the same dose of rocuronium, the time required for the first twitch to decrease to 80% of the control value was delayed in hyperventilation compared to normal ventilation. Conclusions:
This case report and computational simulation suggest that respiratory alkalosis might delay the action of rocuronium. It is necessary to consider the delayed action of rocuronium when hyperventilation is performed.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Fármacos Neuromusculares no Despolarizantes
/
Bloqueo Neuromuscular
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Alcalosis Respiratoria
Límite:
Adult
/
Humans
/
Male
Idioma:
En
Revista:
J Clin Monit Comput
Asunto de la revista:
INFORMATICA MEDICA
/
MEDICINA
Año:
2023
Tipo del documento:
Article
País de afiliación:
Japón