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    How does the Exponential Increase in Rocuronium Dose Effect the Train of Four Parameters in Rats Reversed with Sugammadex? An Animal Model
    (Galenos Publ House, 2023) Köse, Halil Cihan; Kose, Selin Güven; Aydın, Serdar Onur; Kuzucuoğlu, Tamer; Tasargol, Omer; Tulgar, Serkan
    BACKGROUND/AIMS: Sugammadex is a gamma cyclodextrin structured agent used for reversing the effect of steroidal neuromuscular blocking (NMB) agents. The first aim of this study was to evaluate the dose of rocuronium required to re-establish NMB when administered 2 min after its reversal with sugammadex in rats. Also, to monitor the onset times and durations of NMB achieved by variable doses of rocuronium after reversal with sugammadex.MATERIALS AND METHODS: Thirty-five Sprague-Dawley rats were randomly divided into groups including control and four experimental groups. The control group was designed to determine the onset time and duration of NMB induced by 1.2 mg/kg rocuronium. In the control group, no sugammadex was applied. In the experimental groups, rocuronium (1.2 mg/kg) was reversed with sugammadex (4 mg/kg). Subsequently, experimental groups were administered various doses of rocuronium. Groups were named according to the rocuronium dose administered (group 2.4, group 3.6, group 4.8 and group 6.0). Rats in all groups were monitored with train of four.RESULTS: In group 2.4, rocuronium did not ensure NMB. In group 3.6, NMB occurredin only 3 rats. All rats in groups 4.8 and 6.0 achieved complete NMB. There was no statistically significant difference in the onset time of NMB in 4.8 and 6.0 groups (p<0.05). The mean duration of NMB in the experimental groups was significantly shorter than that in the control group (p<0.01).CONCLUSION: Sufficient muscle relaxation and intubation conditions could be achieved with 3.6 mg/kg, 4.8 mg/kg, and 6.0 mg/kg doses of rocuronium as short as 2 min after sugammadex.