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Rocuronium pharmacokinetics and pharmacodynamics in the adductor pollicis and masseter muscles
Author(s) -
Vega E. A.,
Ibacache M. E.,
Anderson B. J.,
Holford N. H. G.,
Nazar C. E.,
Solari S.,
Allende F. A.,
Cortínez L. I.
Publication year - 2016
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12703
Subject(s) - adductor pollicis muscle , medicine , rocuronium , pharmacodynamics , masseter muscle , pharmacokinetics , anesthesia , adductor muscles , bolus (digestion) , rocuronium bromide , propofol , anatomy , elbow , ulnar nerve
Background The aim of this study was to characterize the dose–effect relationship of rocuronium at the adductor pollicis and masseter muscles. Methods Ten, ASA I, adult patients, received a bolus dose of rocuronium 0.3 mg/kg during propofol based anesthesia. Train‐of‐four (TOF) was simultaneously monitored at the masseter and the adductor pollicis muscles until recovery. Rocuronium arterial serum concentrations were measured during 120 min. The first twitch of the TOF response was used to characterize the time–effect profile of both muscles using pharmacokinetic–pharmacodynamic analysis in NONMEM. A decrease in NONMEM objective function (∆OFV) of 3.84 points for an added parameter was considered significant at the 0.05 level. Results Onset time at the masseter (mean ± SD, 1.5 ± 0.9 min) was faster than at the adductor pollicis (2.7 ± 1.4 min, P < 0.05). Recovery, measured as the time to TOF ratio = 0.9 was similar between muscles 29.9 ± 6.7 (adductor pollicis) vs. 29.3 ± 8.1 (masseter). ( P = 0.77). The estimated pharmacodynamic parameters [mean (95% CI)] of the adductor pollicis muscle and the masseter muscle were; plasma effect‐site equilibration half‐time (teq) 3.25 (2.34, 3.69) min vs. 2.86 (1.83, 3.29) min, (∆OFV 383.665); Ce 50 of 1.24 (1.13, 1.56) mg/l vs. 1.19 (1.00, 1.21) mg/l, (∆OFV 184.284); Hill coefficient of 3.97 (3.82, 5.62) vs. 4.68 (3.83, 5.71), (∆OFV 78.906). Conclusions We found that the masseter muscle has faster onset of blockade and similar recovery profile than adductor pollicis muscle. These findings were best, explained by a faster plasma effect‐site equilibration of the masseter muscle to rocuronium.