Rocuronium Desflurane

In addition to the medicines mentioned above, a number of opiate- and non-opiate-based analgesics, including COX-2 inhibitors, anaesthetics (e.g. propofol, desflurane, sevoflurane, ropivacaine, levobupivacaine and remifentanil), neuromuscular blockers (e.g. rocuronium bromid, zemuron, cisatracuiium, doxacurium. 

Both desflurane and sevoflurane significantly increase the neuromuscular blocking effects of rocuronium compared with isoflurane or propofol (20,21). 

Wulf H, Ledowski T, Linstedt U, Proppe D, Sitzlack D. Neuromuscular blocking effects of rocuronium during desflurane, isoflurane, and sevoflurane anaesthesia. Can J Anaesth 1998 45(6) 526-32. 

Both desflurane and sevoflurane significantly increase the neuromuscular blocking effects of rocuronium compared with isoflurane or propofol (41,42). The effective doses of rocuronium for 50% depression of single twitch height were 95,120,130, and 150 pg/kg for desflurane, sevoflurane, isoflurane, and propofol respectively. There were no differences in recovery profiles between the four drugs using equieffective doses. Desflurane, sevoflurane, and to a lesser extent isoflurane, also potentiated the neuromuscular blocking effect of cisatracurium by 30% compared with propofol (43,44). 

Bock M, Klippel K, Nitsche B, Bach A, Martin E, Motsch J. Rocuronium potency and recovery characteristics during steady-state desflurane, sevoflurane, isoflurane or propofol anaes-diesia. BrJ Anaesth (2000) 84, 43-7. 

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