Literature DB >> 27909595

Effect of Smoking on Reversing Neuromuscular Block.

Ömür Öztürk1, Gülbin Yalçın Sezen2, Handan Ankaralı3, Onur Özlü2, Yavuz Demiraran2, Hakan Ateş2, Burhan Dost2.   

Abstract

OBJECTIVE: Rocuronium is a non-depolarising, intermediate-acting, monoquaternary amino steroid and was brought into clinical use as a potentially ideal muscle relaxant. Post-operative residual curarisation (PORC) results from the prolonged effects of non-depolarising neuromuscular blocking agents. This is a common problem and seriously affects patient safety. No recent study has investigated the effects of sugammadex on smokers, which is often used to restore neuromuscular block and avoid PORC. This study compares the severity of the effects of sugammadex used for antagonising rocuronium bromide and antagonism durations in smokers and non-smokers.
METHODS: This randomised, prospective study included 40 patients scheduled for elective surgery and belonging to classes I and II based the American Society of Anesthesiologists classification, who were either smokers for at least 10 years or non-smokers. Patients underwent routine and neuromuscular monitoring. At induction, 2 mg kg-1 propofol and 1 mcg kg-1 intravenous fentanyl were applied. After the loss of eyelash reflex, 0.6 mg kg-1 intravenous rocuronium was administered. Patients were intubated at train of four (TOF) 2. Anaesthesia was continued with 50% O2+50% air and 2% sevoflurane. Rocuronium, 0.15 mg kg-1, was administered at TOF 2 during the operation. At the end of the operation, 2 mg kg-1 sugammadex was administered. The times until TOF 0.7, 0.8 and 0.9 were recorded.
RESULTS: Intubation time was 132.8±46.4 s for smokers and 127.6±32.7 s for non-smokers. After sugammadex administration, the time to TOF 0.7 was 153.3±54.7 s in smokers and 125±67.2 s in non-smokers. The times were 178.4±58.8 and 146.6±72.6 s for TOF 0.8 and 200.8±55.8 s and 170.4±77.8 s for TOF 0.9 in smokers and non-smokers, respectively.
CONCLUSION: Although not statistically significant, the time to reach each TOF was longer for smokers. Larger populations and different perspectives are needed to find if sugammadex use is affected by smoking, which has negative effects on the body.

Entities:  

Keywords:  General anaesthesia; smoking; sugammadex

Year:  2016        PMID: 27909595      PMCID: PMC5019872          DOI: 10.5152/TJAR.2016.97720

Source DB:  PubMed          Journal:  Turk J Anaesthesiol Reanim        ISSN: 2149-276X


  20 in total

1.  Smoking does not alter the dose-requirements and the pharmacodynamics of rocuronium.

Authors:  F K Pühringer; P Keller; A Löckinger; A Kleinsasser; A Scheller; C Raedler; C Keller
Journal:  Can J Anaesth       Date:  2000-04       Impact factor: 5.063

Review 2.  Residual neuromuscular blockade. Incidence and relevance.

Authors:  L I Eriksson
Journal:  Anaesthesist       Date:  2000-04       Impact factor: 1.041

3.  Smoking increases the requirement for rocuronium.

Authors:  P Rautoma; N Svartling
Journal:  Can J Anaesth       Date:  1998-07       Impact factor: 5.063

Review 4.  Postoperative residual curarisation: incidence, aetiology and associated morbidity.

Authors:  G D Shorten
Journal:  Anaesth Intensive Care       Date:  1993-12       Impact factor: 1.669

Review 5.  Smoking and drug metabolism.

Authors:  G W Dawson; R E Vestal
Journal:  Pharmacol Ther       Date:  1981       Impact factor: 12.310

6.  Sugammadex reversal of rocuronium-induced neuromuscular blockade: a comparison with neostigmine-glycopyrrolate and edrophonium-atropine.

Authors:  Ozlem Sacan; Paul F White; Burcu Tufanogullari; Kevin Klein
Journal:  Anesth Analg       Date:  2007-03       Impact factor: 5.108

7.  Effect of age, sex and anaesthetic technique on the pharmacokinetics of atracurium.

Authors:  C J Parker; J M Hunter; S L Snowdon
Journal:  Br J Anaesth       Date:  1992-11       Impact factor: 9.166

8.  Postoperative residual curarization: clinical observation in the post-anesthesia care unit.

Authors:  Chih-Chung Tsai; Ham-See Chung; Po-Liang Chen; Chong-Ming Yu; Ming-Shan Chen; Chian-Lang Hong
Journal:  Chang Gung Med J       Date:  2008 Jul-Aug

9.  A survey of current management of neuromuscular block in the United States and Europe.

Authors:  Mohamed Naguib; Aaron F Kopman; Cynthia A Lien; Jennifer M Hunter; Adriana Lopez; Sorin J Brull
Journal:  Anesth Analg       Date:  2009-11-12       Impact factor: 5.108

Review 10.  A systematic review of sugammadex vs neostigmine for reversal of neuromuscular blockade.

Authors:  A Abad-Gurumeta; J Ripollés-Melchor; R Casans-Francés; A Espinosa; E Martínez-Hurtado; C Fernández-Pérez; J M Ramírez; F López-Timoneda; J M Calvo-Vecino
Journal:  Anaesthesia       Date:  2015-12       Impact factor: 6.955

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  2 in total

1.  The Negative Influence of Cigarette Smoke on Passive Smokers-Deteriorated Pulmonary Function Tests and Increased Urine Cotinine Levels.

Authors:  Yahya Yıldız; İbrahim Özgür Önsel; Bahadır Çiftçi; Murat Uğurlucan
Journal:  Turk J Anaesthesiol Reanim       Date:  2019-02-19

2.  Passive Smoking Also Affects Recovery from Anaesthesia.

Authors:  Ömer Lütfi Erhan; Abdurrahman İleri; Oğuz Kağan Bulut; Ayşe Belin Özer
Journal:  Turk J Anaesthesiol Reanim       Date:  2017-04-27
  2 in total

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