European Journal of Molecular & Clinical Medicine

Background: Rocuronium bromide, a mono quaternary amino steroid with a short onset and an intermediate duration of action, is currently one of the most commonly used neuromuscular blocking agent. In common with vecuronium, hepatic uptake & biliary excretion have been suggested to be the main mechanism of rocuronium metabolism with renal elimination accounting for 10-20% of its overall excretion. This study was conducted to investigate the neuromuscular effects of 0.6mg/kg rocuronium under general anaesthesia in patients with and without renal failure.
Methodology: This prospective observational study includes 110 patients (pts.) divided into two groups, Group ‘S’ (n=55) pts. with renal failure and Group ‘C’ (n=55) without renal failure. Neuromuscular transmission was monitored, parameters recorded were onset, time to maximal block, time to recovery of first twitch response to 25%, 50%, 75% and 90% of base line, time to recovery of train-of-four (TOF) ratio of 70% and recovery index 25% - 75%.
Results: In both the groups demographic data were similar. Both onset time and maximum block for rocuronium were comparable in group S and group C, found not significant. Time to recovery of first twitch response to 25%, 50%, 75% and 90% of baseline, time for recovery of TOF ratio to 70% and recovery index were significantly prolonged in group S compared to group C.
Conclusion: Rocuronium can be used with caution in patients with renal disease and monitoring of neuromuscular block in this group of patients is essential.