Dexamethasone decreases the duration of rocuronium-induced neuromuscular block A randomised controlled study

BACKGROUND Several drugs influence the time course of neuromuscular block during general anaesthesia. OBJECTIVE To evaluate the effect of a single dose of dexamethasone 8 mg on the time course of a rocuronium-induced neuromuscular block. DESIGN A randomised controlled, unblinded, monocentre trial. SETTING Kreiskrankenhaus Dormagen, Dormagen, Germany. PATIENTS One hundred and eight adult patients scheduled for elective gynaecological laparoscopic surgery allocated to three groups. INTERVENTIONS Patients received dexamethasone 8 mg intravenously 2 to 3 h prior to surgery (Group A), during induction of anaesthesia (Group B) or after recovery of the neuromuscular block (Group C, control). MAIN OUTCOME MEASURES The time course of the neuromuscular block of rocuronium 0.3 mg kg(-1) was assessed using acceleromyography. The primary end point was the time from start of injection of rocuronium until recovery to a train-pof-pfour ratio of 0.9. RESULTS The clinical duration was decreased in Group A (15.8 +/- 4.5 min) compared with Group B (18.7 +/- 5.8 min; P = 0.031). The recovery index was reduced in Group A (6.8 +/- 1.8 min) compared with Group B (8.1 +/- 2.6 min; P = 0.018) and Group C (8.3 +/- 2.8 min; P = 0.01). The recovery to a train-pof-pfour ratio of 0.9 was shorter in Group A (30.4 +/- 6.9 min) than in Groups B (36.3 +/- 10.7 min; P 0.031) and C (36.8 +/- 11.3 min; P = 0.02). CONCLUSION A single dose of dexamethasone 8 mg attenuated rocuronium-pinduced block by 15 to 20% if administered 2 to 3 h prior to induction of anaesthesia. However, the administration of dexamethasone during induction of anaesthesia did not influence the time course of the neuromuscular block