Effect-Site Concentration of Rocuronium at the Time of Recovery and Risk of Recurarization in the Presence of Antagonism of Neuromuscular Block by Sugammadex

F. Yasuma, O. Nagata, Sae Sekiguchi, Y. Maehara, Y. Matsuki, K. Shigemi
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Abstract

This single-center prospective study with 50 participants was conducted using train-of-four val-ues obtained intraoperatively by neuromuscular monitoring and pharmacokinetics-pharmacodynam-ics(PK-PD)modeling for the rocuronium-sugammadex complex. Individual changes in the effect-site concentration of free rocuronium after administration and the effect-site concentrations of rocuronium at the time of complete recovery(Ce_r)were calculated using the model developed by Kleijn et al. When sugammadex was administered at the recommended dose stated in the package insert, me-dian Ce_r was 0.43μg/mL(interquartile range, 0.29-0.62μg/mL). The effect-site concentration of rocuronium remained below the Ce_r value determined in each case, and none of the participants had symptoms suggestive of residual neuromuscular block or recurarization. The PK-PD model appears to be useful for predicting free rocuronium concentrations.
罗库溴铵在神经肌肉阻滞拮抗下恢复时的效应位点浓度及复发风险
这项涉及50名参与者的单中心前瞻性研究采用术中神经肌肉监测和罗库溴铵-糖马德复合物的药代动力学-药效学(PK-PD)模型获得的4组值进行。使用Kleijn等人建立的模型计算给药后游离罗库溴铵的个体效应位点浓度变化和完全恢复时罗库溴铵的效应位点浓度(Ce_r)。按说明书推荐剂量给药时,Ce_r值为0.43μg/mL(四分位数范围为0.29 ~ 0.62μg/mL)。罗库溴铵的作用部位浓度仍然低于每个病例确定的Ce_r值,并且没有参与者出现提示残留神经肌肉阻滞或复发的症状。PK-PD模型似乎对预测游离罗库溴铵浓度有用。
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