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Possible augmentation of neuromuscular blockade by propofol during recovery from rocuronium

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Abstract

Propofol is a widely used drug in anesthesia practice, and its pharmacological characteristics are well known. However, propofol is not known for neuromuscular effects. As part of clinical neuromuscular monitoring, the neuromuscular responses to train-of-four (TOF) stimulation were monitored and recorded. We observed, in two cases of balanced anesthesia maintained by desflurane and fentanyl, that administration of a small dose of propofol during almost complete recovery from rocuronium in two patients resulted in marked decreases of both T1 (first twitch response of the TOF) and the TOF ratio. This neuromuscular block dissipated in both patients without any subsequent neuromuscular effects. These two observations provide visual confirmation of the possible impact of propofol on recovery from a rocuronium neuromuscular blockade.

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Acknowledgments

The authors are indebted to the patients, our anesthesia colleagues, and the surgical teams for their support and cooperation. The authors thank Gertrud Haeseler, MD, PhD (Associate Professor, Hannover Medical School) for her contribution to the discussion of pharmacological aspects. Financial support was provided by the Department of Anesthesia and Perioperative Care University of California San Francisco.

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Authors and Affiliations

  1. Department of Anesthesia and Perioperative Care, University of California San Francisco, 521 Parnassus Avenue, Box 0648, San Francisco, CA, 94143, USA

    Heiner Ruschulte, Theresa A. Ward, Ronald D. Miller & Matthias R. Braehler

  2. Department of Anesthesiology and Intensive Care Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

    Heiner Ruschulte

Authors
  1. Heiner Ruschulte
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  2. Theresa A. Ward
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  3. Ronald D. Miller
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  4. Matthias R. Braehler
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Correspondence to Heiner Ruschulte.

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Ruschulte, H., Ward, T.A., Miller, R.D. et al. Possible augmentation of neuromuscular blockade by propofol during recovery from rocuronium. J Anesth 25, 438–441 (2011). https://doi.org/10.1007/s00540-011-1109-4

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  • DOI: https://doi.org/10.1007/s00540-011-1109-4

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