Literature DB >> 16645446

Geographic regional differences in rocuronium bromide dose-response relation and time course of action: an overlooked factor in determining recommended dosage.

Ashraf A Dahaba1, Seth I Perelman, David M Moskowitz, Henry L Bennett, Aryeh Shander, Zhaoyang Xiao, Lin Huang, Gang An, Helmar Bornemann, Georg Wilfinger, Barbara Hager, Peter H Rehak, Werner F List, Helfried Metzler.   

Abstract

BACKGROUND: Geographic location is not acknowledged as a stratifying factor that can directly affect drug potency, because drugs are still licensed with the same recommended dose for different geographic regions. The aim of the current study was to compare the potency and duration of action of rocuronium bromide in 54 patients in three countries with different life habits, diet, and ambient conditions, namely white Austrians, white North Americans, and Han Chinese in China.
METHODS: Neuromuscular block of six consecutive 50-microg/kg rocuronium incremental doses followed by 300 microg/kg was evaluated using the Relaxometer mechanomyograph (Groningen University, Groningen, Holland). Dose-response curves were created using log-dose-probit transformation. The authors compared rocuronium bromide ED50, ED90, and ED95 (effective doses required for 50%, 90%, and 95% first twitch depression, respectively) as well as Dur25 and Dur0.8 (times from last incremental dose administration until 25% first twitch and 0.8 train-of-four ratio recovery, respectively) in patients of the three countries.
RESULTS: Rocuronium ED50, ED90, and ED95 were significantly higher in Austrian patients (258 +/- 68, 530 +/- 159, and 598 +/- 189 microg/kg) and Chinese patients (201 +/- 59, 413 +/- 107, and 475 +/- 155 microg/kg) compared with American patients (148 +/- 48, 316 +/- 116, and 362 +/- 149 microg/kg, respectively). Dur25 and Dur0.8 were significantly shorter in Austrian patients (22.3 +/- 5.5 and 36.9 +/- 12.8 min) and Chinese patients (30.4 +/- 7.5 and 45.7 +/- 15.9 min) compared with American patients (36.7 +/- 8.5 and 56.2 +/- 16.7 min, respectively).
CONCLUSIONS: The authors demonstrated a significant difference in rocuronium potency and duration of action among patients in the three countries. Larger studies are required for determining dosage recommendations for different geographic regions.

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Year:  2006        PMID: 16645446     DOI: 10.1097/00000542-200605000-00010

Source DB:  PubMed          Journal:  Anesthesiology        ISSN: 0003-3022            Impact factor:   7.892


  9 in total

1.  Effective method of continuous rocuronium administration based on effect-site concentrations using a pharmacokinetic/pharmacodynamic model during propofol-remifentanil anesthesia.

Authors:  Takahiro Moriyama; Akira Matsunaga; Osamu Nagata; Kei Enohata; Tomomi Kamikawaji; Erika Uchino; Yuichi Kanmura
Journal:  J Anesth       Date:  2015-03-01       Impact factor: 2.078

2.  Letter to the editor: considering the effects of deep neuromuscular blockade on endoscopic surgical conditions during transurethral resection of a bladder tumor (TURB).

Authors:  K I Albers; C H Martini; G J Scheffer; M C Warlé
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3.  Effective doses of cisatracurium in the adult and the elderly.

Authors:  Jeong Ho Kim; Yoon Chan Lee; Soo Il Lee; Sang Yoong Park; So Ron Choi; Jong Hwan Lee; Chan Jong Chung; Seung Cheol Lee
Journal:  Korean J Anesthesiol       Date:  2016-09-08

Review 4.  Factors that affect the onset of action of non-depolarizing neuromuscular blocking agents.

Authors:  Yong Beom Kim; Tae-Yun Sung; Hong Seuk Yang
Journal:  Korean J Anesthesiol       Date:  2017-09-28

5.  Effects of magnesium sulphate on the onset time of rocuronium at different doses: a randomized clinical trial.

Authors:  Carlos Eduardo David de Almeida; Lidia Raquel de Carvalho; Carla Vasconcelos Caspar Andrade; Paulo do Nascimento; Guilherme Antonio Moreira de Barros; Norma Sueli Pinheiro Modolo
Journal:  Braz J Anesthesiol       Date:  2021-08-14

6.  Risk factors for administration of additional reversal following neuromuscular blockade with rocuronium in children: A retrospective case-control study.

Authors:  Susan R Vishneski; Amit K Saha; Madeline R Fram; Leah B Templeton; Lisa K Lee; Douglas G Ririe; Eduardo Javier Goenaga-Diaz; Laura Daniela Smith; Thomas Wesley Templeton
Journal:  Paediatr Anaesth       Date:  2022-05-01       Impact factor: 2.129

7.  Sugammadex versus neostigmine reversal of moderate rocuronium-induced neuromuscular blockade in Korean patients.

Authors:  Tiffany Woo; Kyo Sang Kim; Yon Hee Shim; Mi Kyeong Kim; Suk Min Yoon; Young Jin Lim; Hong Seuk Yang; Phillip Phiri; Jin Young Chon
Journal:  Korean J Anesthesiol       Date:  2013-12-26

8.  The neuromuscular effects of rocuronium under sevoflurane-remifentanil or propofol-remifentanil anesthesia: a randomized clinical comparative study in an Asian population.

Authors:  Sangseok Lee; Young Jin Ro; Won Uk Koh; Tomoki Nishiyama; Hong-Seuk Yang
Journal:  BMC Anesthesiol       Date:  2016-08-22       Impact factor: 2.217

9.  Infusion dose requirement of rocuronium in patients on phenytoin therapy - A prospective comparative study.

Authors:  Veena Sheshadri; Arathi Radhakrishnan; Kusuma Halemani; Venkatesh H Keshavan
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  9 in total

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