At therapeutic concentration bupivacaine causes neuromuscular blockade and enhances rocuronium-induced blockade
BackgroundPartially paralyzed patients may be placed in the risk of pharyngeal dysfunction. Bupivacaine acts as acetylcholine receptor ion channel blocker and may synergistically interact with rocuronium to augment NM blockade. Thus, this study aims to elucidate whether or not, at a therapeutic conc...
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| Format: | Article |
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Korean Society of Anesthesiologists
2012-05-01
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| Series: | Korean Journal of Anesthesiology |
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| Online Access: | http://ekja.org/upload/pdf/kjae-62-468.pdf |
| _version_ | 1819045207430135808 |
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| author | Ji Hyeon Lee Soo-Il Lee Seung Cheol Lee So Ron Choi Won Ji Rhee |
| author_facet | Ji Hyeon Lee Soo-Il Lee Seung Cheol Lee So Ron Choi Won Ji Rhee |
| author_sort | Ji Hyeon Lee |
| collection | DOAJ |
| description | BackgroundPartially paralyzed patients may be placed in the risk of pharyngeal dysfunction. Bupivacaine acts as acetylcholine receptor ion channel blocker and may synergistically interact with rocuronium to augment NM blockade. Thus, this study aims to elucidate whether or not, at a therapeutic concentration, bupivacaine by itself may cause NM blockade and reduce an effective concentration of rocuronium.MethodsTwenty-two left phrenic nerve-hemidiaphragms (Male SD rats, 150-250 g) were hung in Krebs solution. Three consecutive ST, 0.1 Hz and one TT, 50 Hz for 1.9 s were obtained before drug application and at each new drug concentration. A concentration of bupivacaine in Krebs solution (n = 5) was cumulatively increased by way of 0.01, 0.1, 1, (1, 2, 3, 4, 5, 6, 7) × 10 µM. In a Krebs solution, pre-treated with bupivacaine 0 (n = 5), 0.1 (n = 5), 1.0 (n = 5), 10 (n = 2) µM, and then concentrations of rocuronium were cumulatively increased by way of 1, 3, 5, 7, 9, 12, 14, 16, 18, 20 µM. EC for each experiment were determined by a probit. The EC50's of rocuronium were compared using a Student's t-test with Bonferroni's correction. Differences were considered significant when P < 0.05.ResultsThe potency of bupivacaine for normalized TF was 11.4 (± 1.1) µM. Below 30 µM of bupivacaine, the single twitch potentiation sustained despite the development of tetanic fade and partial inhibition of PTT. Bupivacaine significantly facilitated the NM blockade induced by rocuronium.ConclusionsClinicians should be aware that bupivacaine by itself at its therapeutic concentration inhibit NM conduction and enhances rocuronium-induced muscle relaxation. |
| first_indexed | 2024-12-21T10:24:54Z |
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| id | doaj.art-7654c0e4037a49f3b23b706a2faab324 |
| institution | Directory Open Access Journal |
| issn | 2005-6419 2005-7563 |
| language | English |
| last_indexed | 2024-12-21T10:24:54Z |
| publishDate | 2012-05-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Korean Journal of Anesthesiology |
| spelling | doaj.art-7654c0e4037a49f3b23b706a2faab3242022-12-21T19:07:20ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632012-05-0162546847310.4097/kjae.2012.62.5.4687343At therapeutic concentration bupivacaine causes neuromuscular blockade and enhances rocuronium-induced blockadeJi Hyeon Lee0Soo-Il Lee1Seung Cheol Lee2So Ron Choi3Won Ji Rhee4Department of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan, Korea.Department of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan, Korea.Department of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan, Korea.Department of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan, Korea.Department of Anesthesiology and Pain Medicine, Dong-A University College of Medicine, Busan, Korea.BackgroundPartially paralyzed patients may be placed in the risk of pharyngeal dysfunction. Bupivacaine acts as acetylcholine receptor ion channel blocker and may synergistically interact with rocuronium to augment NM blockade. Thus, this study aims to elucidate whether or not, at a therapeutic concentration, bupivacaine by itself may cause NM blockade and reduce an effective concentration of rocuronium.MethodsTwenty-two left phrenic nerve-hemidiaphragms (Male SD rats, 150-250 g) were hung in Krebs solution. Three consecutive ST, 0.1 Hz and one TT, 50 Hz for 1.9 s were obtained before drug application and at each new drug concentration. A concentration of bupivacaine in Krebs solution (n = 5) was cumulatively increased by way of 0.01, 0.1, 1, (1, 2, 3, 4, 5, 6, 7) × 10 µM. In a Krebs solution, pre-treated with bupivacaine 0 (n = 5), 0.1 (n = 5), 1.0 (n = 5), 10 (n = 2) µM, and then concentrations of rocuronium were cumulatively increased by way of 1, 3, 5, 7, 9, 12, 14, 16, 18, 20 µM. EC for each experiment were determined by a probit. The EC50's of rocuronium were compared using a Student's t-test with Bonferroni's correction. Differences were considered significant when P < 0.05.ResultsThe potency of bupivacaine for normalized TF was 11.4 (± 1.1) µM. Below 30 µM of bupivacaine, the single twitch potentiation sustained despite the development of tetanic fade and partial inhibition of PTT. Bupivacaine significantly facilitated the NM blockade induced by rocuronium.ConclusionsClinicians should be aware that bupivacaine by itself at its therapeutic concentration inhibit NM conduction and enhances rocuronium-induced muscle relaxation.http://ekja.org/upload/pdf/kjae-62-468.pdfbupivacaineneuromuscular blockaderocuronium |
| spellingShingle | Ji Hyeon Lee Soo-Il Lee Seung Cheol Lee So Ron Choi Won Ji Rhee At therapeutic concentration bupivacaine causes neuromuscular blockade and enhances rocuronium-induced blockade Korean Journal of Anesthesiology bupivacaine neuromuscular blockade rocuronium |
| title | At therapeutic concentration bupivacaine causes neuromuscular blockade and enhances rocuronium-induced blockade |
| title_full | At therapeutic concentration bupivacaine causes neuromuscular blockade and enhances rocuronium-induced blockade |
| title_fullStr | At therapeutic concentration bupivacaine causes neuromuscular blockade and enhances rocuronium-induced blockade |
| title_full_unstemmed | At therapeutic concentration bupivacaine causes neuromuscular blockade and enhances rocuronium-induced blockade |
| title_short | At therapeutic concentration bupivacaine causes neuromuscular blockade and enhances rocuronium-induced blockade |
| title_sort | at therapeutic concentration bupivacaine causes neuromuscular blockade and enhances rocuronium induced blockade |
| topic | bupivacaine neuromuscular blockade rocuronium |
| url | http://ekja.org/upload/pdf/kjae-62-468.pdf |
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