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http://dx.doi.org/10.4097/kja.d.17.00011

Effects of adenosine receptor agonist on the rocuronium-induced neuromuscular block and sugammadex-induced recovery  

Kim, Yong Beom (Department of Anesthesiology and Pain Medicine, Gil Medical Center, Gachon University College of Medicine)
Lee, Sangseok (Sanggye Paik Hospital, Inje University College of Medicine)
Choi, Hey Ran (Seoul Paik Hospital, Inje University College of Medicine)
In, Junyong (Ilsan Hospital, Dongguk University College of Medicine)
Chang, Young Jin (Department of Anesthesiology and Pain Medicine, Gil Medical Center, Gachon University College of Medicine)
Kim, Ha Jung (Asan Medical Center, Ulsan University College of Medicine)
Ro, Young Jin (Asan Medical Center, Ulsan University College of Medicine)
Yang, Hong-Seuk (Asan Medical Center, Ulsan University College of Medicine)
Publication Information
Korean Journal of Anesthesiology / v.71, no.6, 2018 , pp. 476-482 More about this Journal
Abstract
Background: Several types of receptors are found at neuromuscular presynaptic membranes. Presynaptic inhibitory $A_1$ and facilitatory $A_{2A}$ receptors mediate different modulatory functions on acetylcholine release. This study investigated whether adenosine $A_1$ receptor agonist contributes to the first twitch tension (T1) of train-of-four (TOF) stimulation depression and TOF fade during rocuronium-induced neuromuscular blockade, and sugammadex-induced recovery. Methods: Phrenic nerve-diaphragm tissues were obtained from 30 adult Sprague-Dawley rats. Each tissue specimen was randomly allocated to either control group or 2-chloroadenosine (CADO, $10{\mu}M$) group. One hour of reaction time was allowed before initiating main experimental data collection. Loading and boost doses of rocuronium were sequentially administered until > 95% depression of the T1 was achieved. After confirming that there was no T1 twitch tension response, 15 min of resting time was allowed, after which sugammadex was administered. Recovery profiles (T1, TOF ratio [TOFR], and recovery index) were collected for 1 h and compared between groups. Results: There were statistically significant differences on amount of rocuronium (actually used during experiment), TOFR changes during concentration-response of rocuronium (P = 0.04), and recovery profiles (P < 0.01) of CADO group comparing with the control group. However, at the initial phase of this experiment, dose-response of rocuronium in each group demonstrated no statistically significant differences (P = 0.12). Conclusions: The adenosine $A_1$ receptor agonist (CADO) influenced the TOFR and the recovery profile. After activating adenosine receptor, sugammadex-induced recovery from rocuronium-induced neuromuscular block was delayed.
Keywords
Adenosine $A_1$-receptor; Neuromuscular junction; Neuromuscular nondepolarizing agents; Rocuronium; Sugammadex;
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