Alterations in the Effect of Rocuronium in Patients with Renal Failure or Liver Disease Who Underwent Transplantation Surgery

Abstract

 Rocuronium is rapidly taken up in the liver and the majority of it is excreted into the bile, with relatively little going into the urine. The duration of action of rocuronium is not altered or prolonged in patients with renal failure, but is consistently prolonged in patients with liver disease. In the case of liver transplantation, increases in rocuronium plasma concentrations and prolongation in recovery time from rocuronium-induced neuromuscular block during the neohepatic phase suggest impaired organ function after reperfusion of the graft liver. Rocuronium should be used with caution in patients with renal failure or liver disease who underwent liver transplantation surgery. Monitoring of neuromuscular block in these groups of patients is essential.