Recovery from rocuronium-induced neuromuscular block was longer in the larynx than in the pelvic limb of anesthetized dogs.

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Recovery from rocuronium-induced neuromuscular block was longer in the larynx than in the pelvic limb of anesthetized dogs.

Vet Anaesth Analg. 2017 Jan 07;:

Authors: Sakai DM, Martin-Flores M, Romano M, Tseng CT, Campoy L, Gleed RD, Cheetham J

Abstract
OBJECTIVE: To determine if neuromuscular monitoring at the pelvic limb accurately reflects neuromuscular function in the larynx after administration of rocuronium in anesthetized dogs.
STUDY DESIGN: Prospective experimental study.
ANIMALS: Six healthy Beagle dogs.
METHODS: Anesthesia was maintained in dogs with isoflurane and a continuous infusion of dexmedetomidine. Rocuronium (0.6 mg kg(-1)) was administered intravenously to induce neuromuscular block. Train-of-four (TOF) impulses were applied to the left recurrent laryngeal nerve (RLn) and the peroneal nerve (Pn). The evoked TOF ratio (TOFR; T4:T1) was measured with electromyography (EMG) simultaneously at the larynx and at the pelvic limb. Spontaneous recoveries of T1 to 25% (T125%) and 75% (T175%) of twitch height, and to TOFR of 0.70 and 0.90 (TOFR0.90) at each EMG site were compared.
RESULTS: Data from five dogs were analyzed. Times to T125% were similar at the pelvic limb and larynx when measured by EMG; time to T175% was slower at the larynx by 6±4 minutes (p=0.012). The larynx had a slower recovery to TOFR0.70 (41±13 minutes) and TOFR0.90 (45±13 minutes) than did the pelvic limb [29±8 minutes (p=0.011) and 33±9 minutes (p=0.003), respectively]. When the pelvic limb EMG returned to TOFR0.70 and TOFR0.90, the larynx EMG TOFR0.70 and TOFR0.90 values were 0.32±0.12 (p=0.001) and 0.38±0.13 (p=0.001), respectively.
CONCLUSIONS AND CLINICAL RELEVANCE: After administration of rocuronium, neuromuscular function assessed by EMG recovered approximately 36% slower at the larynx than at the pelvic limb. The results in these dogs suggest that quantitative neuromuscular monitoring instrumented at a pelvic limb may be unable to exclude residual block at the larynx in anesthetized dogs.

PMID: 28238585 [PubMed - as supplied by publisher]

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