[Rocuronium (esmerone) in anesthesia during surgery under extracorporeal circulation]

Area of Science:

• Anesthesiology
• Pharmacology
• Cardiovascular Surgery

Background:

• Rocuronium is a novel aminosteroidal neuromuscular blocking agent.
• Its use in cardiac surgery requires evaluation of its safety and efficacy, particularly regarding early patient recovery.

Purpose of the Study:

• To assess the neuromuscular, hemodynamic, and histamine-releasing effects of rocuronium.
• To evaluate its suitability for maintaining anesthesia in cardiac surgical patients undergoing extracorporeal circulation with the goal of early tracheal extubation.

Main Methods:

• A study involving 22 adult cardiac surgical patients undergoing extracorporeal circulation.
• Administration of rocuronium at specific doses during different surgical phases.
• Monitoring of neuromuscular conduction (NMC), hemodynamic parameters, and plasma histamine levels.

Main Results:

• Rocuronium (0.6 mg/kg) did not impair cardiac function or elevate histamine levels.
• A moderate vagolytic effect was observed in 45% of patients.
• Neuromuscular conduction block was maintained with reduced doses during hypothermic extracorporeal circulation.
• 95% recovery of neuromuscular conduction occurred within 63 ± 6 minutes after infusion cessation.
• Early tracheal extubation was achieved in 68% of patients (69 ± 7.6 minutes post-operation) with no residual myoplegia.

Conclusions:

• Rocuronium is a safe and effective muscle relaxant for cardiac surgery.
• Its predictable recovery profile facilitates early tracheal extubation and patient mobilization after extracorporeal circulation.
• The agent demonstrates favorable hemodynamic and histamine release profiles in this patient population.