Pharmacodynamics of rocuronium in sickle cell patients

Abstract

BackgroundSickle cell disease is the most widespread genetic disease in the world. The chronic organ damage due to this disease could lead to variability of responses to the anaesthetic drugs. We analysed the pharmacodynamics response of rocuronium to sickle cell patients. MethodsWe observed and compared the onset time and clinical duration (time to recovery first twitch) of 0.6 mg kg−1 of rocuronium using a TOFscan® monitor, as well as the time before the first incremental dose (time to recovery second twitch), in a group of 22 homozygous sickle cell patients and a group of 23 controls, all programmed for laparoscopic surgical procedures. ResultsThe onset time of rocuronium was longer in sickle cell patients [mean ± SD (extremes)], [6.3 ± 2.1 (1.8–10) min] than in the control group [2.5 ± 0.6 (1.4–3.5) min] (P < 0.01). The clinical duration was shorter in sickle cell patients [19.2 ± 7.1 (13–41) min] when compared to the control group [28.9 ± 6.9 (21–48) min] (P < 0.01). The time before the first incremental dose was shorter in the sickle cell patients group [27.7 ± 7.9 (19–49) min] compared to the control group [39.9 ± 8.7 (30–56) min] (P < 0.01). ConclusionThe onset time of rocuronium was significantly longer with a shorter duration of action in patients with sickle cell disease versus the general population.