Abstract
BackgroundDuring anaesthesia it is not uncommon to administer epinephrine in patients blocked by non-depolarizing muscle relaxants. However, there are few reports on possible interaction of epinephrine with neuromuscular transmission in humans.Case presentationAn otherwise healthy 74-yr-old man underwent transurethral resection of a benign prostatic hyperplasia under total intravenous anaesthesia. Because of repeated drop in heart rate and blood pressure the patient received in total three bolus of epinephrine 5 μg, respectively. Each time this small dose of epinephrine intensified a rocuronium-induced neuromuscular block verified by acceleromygraphy. Further anaesthetic course was uneventful.ConclusionsIn this case reported here small doses of intravenously administered epinephrine markedly prolonged a rocuronium-induced neuromuscular block. Given the widely used co-administration of epinephrine and muscle relaxants possible adrenergic interference with neuromuscular transmission would have implications for daily anaesthetic practice.
Highlights
During anaesthesia it is not uncommon to administer epinephrine in patients blocked by non-depolarizing muscle relaxants
The data was recorded within the context of an observational study investigating the recovery characteristics of a rocuronium-induced neuromuscular block (NMB) during urological surgery
Single boluses of epinephrine caused a remarkable prolonged duration of a rocuronium-induced NMB compared to published data [4]
Summary
In this case reported here small doses of intravenously administered epinephrine markedly prolonged a rocuronium-induced neuromuscular block.
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