Abstract
We evaluated rocuronium-induced neuromuscular blockade and its reversal with sugammadex in 2 pediatric patients with mild and severe Duchenne muscular dystrophy (DMD). After induction of anesthesia with propofol and fentanyl, patients initially received 0.6 mg/kg rocuronium and neuromuscular block was evaluated by contractions of the adductor pollicis muscle to ulnar nerve train-of-four (TOF) stimulation using an acceleromyograph. The onset times of rocuronium were 98 s and 2,102 s in mild and severe DMD patients. Subsequently, intense rocuronium-induced block was determined every 6 min using the post-tetanic count (PTC). Whenever the first response to the PTC stimulus was detected, 0.1 mg/kg rocuronium was additionally administered. When the PTC reappeared after the last dose of rocuronium, 4 mg/kg sugammadex was administered and the time to recover to a TOF ratio of 0.9 was 156 s and 423 s in mild and severe DMD patients, respectively.
Our results indicate that onset and duration of action of rocuronium and sugammadex-facilitated recovery from neuromuscular blockade may be prolonged according to the severity of DMD.
