Prolonged onset and duration of action of rocuronium after accidental subcutaneous injection in a patient with chronic renal failure—a case report
Abstract Background Drugs administered subcutaneously have delayed onset and prolonged duration of action versus those given intravenously. Since the duration of action of rocuronium is prolonged in patients with renal dysfunction, subcutaneous administration of rocuronium to such patients might sig...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2021-02-01
|
| Series: | JA Clinical Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40981-021-00421-3 |
| _version_ | 1818610499485433856 |
|---|---|
| author | Akira Doshu-Kajiura Junko Suzuki Takahiro Suzuki |
| author_facet | Akira Doshu-Kajiura Junko Suzuki Takahiro Suzuki |
| author_sort | Akira Doshu-Kajiura |
| collection | DOAJ |
| description | Abstract Background Drugs administered subcutaneously have delayed onset and prolonged duration of action versus those given intravenously. Since the duration of action of rocuronium is prolonged in patients with renal dysfunction, subcutaneous administration of rocuronium to such patients might significantly prolong its effect. Case presentation A 51-year-old female with chronic renal failure was accidentally administered 1.04 mg/kg rocuronium subcutaneously. Marked prolongation of onset and duration of action of rocuronium were detected on acceleromyography. Slow development of the neuromuscular block was still observed at 100 min after injection. Administration of 4.5 mg/kg sugammadex at 140 min after rocuronium injection facilitated recovery from a train-of-four (TOF) count of 2 to a TOF ratio of 100% within 5 min. No symptoms of postoperative recurarization and upper airway obstruction were observed. Conclusion Neuromuscular monitoring is necessary to evaluate the progress and depth of neuromuscular block, particularly when rocuronium is inadvertently administered subcutaneously. |
| first_indexed | 2024-12-16T15:15:24Z |
| format | Article |
| id | doaj.art-d01365b1d7fc4182a333257bcdd7b4d4 |
| institution | Directory Open Access Journal |
| issn | 2363-9024 |
| language | English |
| last_indexed | 2024-12-16T15:15:24Z |
| publishDate | 2021-02-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | JA Clinical Reports |
| spelling | doaj.art-d01365b1d7fc4182a333257bcdd7b4d42022-12-21T22:26:49ZengSpringerOpenJA Clinical Reports2363-90242021-02-01711310.1186/s40981-021-00421-3Prolonged onset and duration of action of rocuronium after accidental subcutaneous injection in a patient with chronic renal failure—a case reportAkira Doshu-Kajiura0Junko Suzuki1Takahiro Suzuki2Department of Anesthesiology, Nihon University, School of MedicineDepartment of Anesthesiology, Nihon University, School of MedicineDepartment of Anesthesiology, Nihon University, School of MedicineAbstract Background Drugs administered subcutaneously have delayed onset and prolonged duration of action versus those given intravenously. Since the duration of action of rocuronium is prolonged in patients with renal dysfunction, subcutaneous administration of rocuronium to such patients might significantly prolong its effect. Case presentation A 51-year-old female with chronic renal failure was accidentally administered 1.04 mg/kg rocuronium subcutaneously. Marked prolongation of onset and duration of action of rocuronium were detected on acceleromyography. Slow development of the neuromuscular block was still observed at 100 min after injection. Administration of 4.5 mg/kg sugammadex at 140 min after rocuronium injection facilitated recovery from a train-of-four (TOF) count of 2 to a TOF ratio of 100% within 5 min. No symptoms of postoperative recurarization and upper airway obstruction were observed. Conclusion Neuromuscular monitoring is necessary to evaluate the progress and depth of neuromuscular block, particularly when rocuronium is inadvertently administered subcutaneously.https://doi.org/10.1186/s40981-021-00421-3AcceleromyographHemodialysisPharmacodynamicsRapid sequence inductionRocuroniumSubcutaneous injection |
| spellingShingle | Akira Doshu-Kajiura Junko Suzuki Takahiro Suzuki Prolonged onset and duration of action of rocuronium after accidental subcutaneous injection in a patient with chronic renal failure—a case report JA Clinical Reports Acceleromyograph Hemodialysis Pharmacodynamics Rapid sequence induction Rocuronium Subcutaneous injection |
| title | Prolonged onset and duration of action of rocuronium after accidental subcutaneous injection in a patient with chronic renal failure—a case report |
| title_full | Prolonged onset and duration of action of rocuronium after accidental subcutaneous injection in a patient with chronic renal failure—a case report |
| title_fullStr | Prolonged onset and duration of action of rocuronium after accidental subcutaneous injection in a patient with chronic renal failure—a case report |
| title_full_unstemmed | Prolonged onset and duration of action of rocuronium after accidental subcutaneous injection in a patient with chronic renal failure—a case report |
| title_short | Prolonged onset and duration of action of rocuronium after accidental subcutaneous injection in a patient with chronic renal failure—a case report |
| title_sort | prolonged onset and duration of action of rocuronium after accidental subcutaneous injection in a patient with chronic renal failure a case report |
| topic | Acceleromyograph Hemodialysis Pharmacodynamics Rapid sequence induction Rocuronium Subcutaneous injection |
| url | https://doi.org/10.1186/s40981-021-00421-3 |
| work_keys_str_mv | AT akiradoshukajiura prolongedonsetanddurationofactionofrocuroniumafteraccidentalsubcutaneousinjectioninapatientwithchronicrenalfailureacasereport AT junkosuzuki prolongedonsetanddurationofactionofrocuroniumafteraccidentalsubcutaneousinjectioninapatientwithchronicrenalfailureacasereport AT takahirosuzuki prolongedonsetanddurationofactionofrocuroniumafteraccidentalsubcutaneousinjectioninapatientwithchronicrenalfailureacasereport |