ISSN: 1449-1907International Journal of Medical Sciences
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Int J Med Sci 2024; 21(6):978-982. doi:10.7150/ijms.95061 This issue Cite
Research Paper
Comparison between conventional-dose and high-dose rocuronium use in general anesthesia for Cesarean section
1. Department of Anesthesia and Pain Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
2. Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Busan, Republic of Korea.
3. Department of Electrical and Computer Engineering, University of California, San Diego (UCSD), USA.
4. Bredis Healthcare Inc., Kwangju, Republic of Korea.
5. Department of Obstetrics and Gynecology, School of Medicine, Pusan National University, Busan, Republic of Korea.
Abstract
Background: There have been few studies comparing the effects of high- and low-dose rocuronium during cesarean section by directly measuring the concentration. Therefore, we conducted a study to examine the blood concentrations and clinical effects of both doses of rocuronium on mothers and fetuses.
Methods: Eighteen patients were randomly assigned to two groups: C Group (0.6 mg/kg), and H Group, (1.0 mg/kg). The primary outcome was the comparison of umbilical vein rocuronium concentration between two groups. We assessed ease of intubation, time from rocuronium administration to some TOF points, post-anesthesia care unit (PACU) stay time, infused remifentanil dose, maternal rocuronium concentration, and Apgar scores.
Results: No differences were observed in demographic data, ease of intubation, PACU stay time, 1 min Apgar scores, umbilical venous blood gas analysis between both groups. However, the time from rocuronium administration to T3 disappearance was shorter (p=0.009) and time to T1 and T2 reappearance were longer (p=0.003, p=0.009) in H group than that in C group. The administered remifentanil dose (p=0.042) was lower in the H group than in the C group. Rocuronium concentrations in the umbilical vein (p=0.004) and maternal vein before cord clamping (p=0.002) and at discharge (p<0.001) were also found to be higher in the H group than in the C group.
Conclusions: We observed no prolongation of PACU stay, and no differences in Apgar scores in H group compared to C group. It suggests that 1.0 mg/kg of rocuronium has no negative effects on the fetus and mother in cesarean section.
Keywords: Anesthesia, General, Anesthesia, Obstetrical, Cesarean Section, Rocuronium
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