Chronic exposure to dexamethasone may not affect sugammadex reversal of rocuronium-induced neuromuscular blockade: an in vivo study on rats

Ha Yeon Park, Hey Ran Choi, Yong Beom Kim, Seok Kyeong Oh, Taehoon Kim, Hong Seuk Yang, Junyong In

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Chronic glucocorticoid exposure is associated with resistance to nondepolariz-ing neuromuscular blocking agents. Therefore, we hypothesized that sugammadex-induced recovery would occur more rapidly in subjects exposed to chronic dexamethasone compared to those who were not exposed. This study evaluated the sugammadex-induced recovery profile after neuromuscular blockade (NMB) in rats exposed to chronic dexamethasone. Methods: Sprague–Dawley rats were allocated to three groups (dexamethasone, control, and pair-fed group) for the in vivo study. The mice received daily intraperitoneal dexametha-sone injections (500 μg/kg) or 0.9% saline for 15 days. To achieve complete NMB, 3.5 mg/ kg rocuronium was administered on the sixteenth day. The recovery time to a train-of-four ratio ≥ 0.9 was measured to evaluate the complete recovery following the sugammadex in-jection. Results: Among the groups, no significant differences were observed in the recovery time to a train-of-four ratio ≥ 0.9 following sugammadex administration (P = 0.531). The time to the second twitch of the train-of-four recovery following rocuronium administration indicated that the duration of NMB was significantly shorter in Group D than that in Groups C and P (P = 0.001). Conclusions: Chronic exposure to dexamethasone did not shorten the recovery time of sugammadex-induced NMB reversal. However, the findings of this study indicated that no adjustments to sugammadex dosage or route of administration is required, even in patients undergoing long-term steroid treatment.

Original languageEnglish
Pages (from-to)275-283
Number of pages9
JournalAnesthesia and Pain Medicine
Volume18
Issue number3
DOIs
StatePublished - Jul 2023

Keywords

  • Dexamethasone
  • Neuromuscular blockade
  • Neuromuscular monitoring
  • Rats
  • Ro-curonium
  • Sugammadex

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