Background: The effect of rocuronium and sugammadex in patients undergoing hepatectomy due to hepatic tumor without preoperative hepatic impairment were investigated.
Methods: We studied 15 patients undergoing hepatectomy and 20 patients undergoing non-hepatic surgery No patients had preoperative hepatic impairment. Anesthesia was induced and maintained with propofol and remifentanil. Train-of-four (TOF) responses of the adductor pollicis to the supramaximal ulnar nerve stimulation were monitored by acceleromyography. A single dose of rocuronium 0.9 mg x kg(-1) was administered, and after spontaneous recovery of T1 to 25%, rocuronium was infused continuously to keep the posttetanic count 1-2. After surgery, sugammadex 4 mg x kg(-1) was administered.
Results: In hepatectomy patients, duration from the administration of rocuronium to recovery of T1 to 25% was longer (88 +/- 20 vs 68 +/- 16 min, P < 0.01), and the total dose of rocuronium used during surgery was less (8.8 +/- 1.7 vs 11.4 +/- 2.7 microg x kg(-1) x min(-1), P < 0.01). However, there were no differences in the duration from administration of sugammadex to recovery of TOF ratio to 0.9 between two groups (138 +/- 55 vs 164 +/- 79 sec, P = 0.29).
Conclusions: Rocuronium-induced neuromuscular block was prolonged in hepatectomy patients even without preoperative hepatic impairment but the reversal with sugammadex was effective.