Влияние дексаметазона на действие рокурония бромида: рандомизированное контролируемое исследование

Георгий Гивиевич Бестаев; К. М. Лебединский

doi:10.21320/1818-474X-2025-4-99-107

No. 4 (2025), SELECTED ISSUES IN ANESTHESIOLOGY

No. 4 (2025)

SELECTED ISSUES IN ANESTHESIOLOGY

Dexamethasone influence on the action of rocuronium bromide: a randomized controlled trial

Published 01.11.2025

Georgy G. Bestaev⁺⁻
K.M. Lebedinskii⁺⁻

Georgy G. Bestaev

North-Ossetian State Medical Academy, Vladikavkaz, Russia

https://orcid.org/0000-0002-1102-7810

K.M. Lebedinskii

North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russia; Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia

https://orcid.org/0000-0002-5752-4812

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Keywords

dexamethasone
neuromuscular blockade
rocuronium
general anesthesia

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Bestaev G.G., Lebedinskii K.M. Dexamethasone influence on the action of rocuronium bromide: a randomized controlled trial. Annals of Critical Care. 2025;(4):99–107. doi:10.21320/1818-474X-2025-4-99-107.

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Abstract

INTRODUCTION: Dexamethasone ability to modulate the effect of a muscle relaxant can apparently be successfully used in small and medium-volume surgeries that require a rapidly occurring and fairly deep, but nevertheless short and easily reversible, neuromuscular block. However, the clinical significance of such effects on anesthesia remains unclear. OBJECTIVE: To study the effect of dexamethasone on neuromuscular block induced by rocuronium. MATERIALS AND METHODS: The study was conducted on 60 patients ASA (American Society of Anesthesiologists) I–II undergoing elective medium-volume surgery. Patients were randomly distributed between two equal groups. In both groups, general anesthesia induction was performed with a combination of intravenous propofol (1.5–2 mg × kg^–1) and fentanyl (2–3 mkg × kg^–1). Аnesthesia maintenance provided with propofol (4–8 mg × kg^–1 × h^–1) and fentanyl (2–3 mkg × kg^–1 × h^–1). For tracheal intubation, rocuronium was used (0.6 mg × kg^–1). Before induction, patients were given either dexamethasone 8 mg (group 1) or the same volume of normal saline (group 2). RESULTS: The time interval from the moment of administration of rocuronium to intubation was 45 (40; 48) seconds in group 1 and 82 (80; 95) sec in group 2 (p = 0.0019). The time of recovery of neuromuscular conduction from the induction dose of rocuronium to the appearance of the first TOF response in group 2 was 40 (38; 50) min, while in group 1 — 30 (29; 33) min. The rate of neuromuscular conduction recovery from the appearance of the first muscle response to extubation in group 2 was 28 (25; 32) min, while in group 1 — 16 (15; 20) min. It is evident that all the studied intervals of neuromuscular conduction recovery in the 1st group are reliably shortened (p < 0.05 for all cases). CONCLUSIONS: Dexamethasone accelerates the recovery rate of non-depolarizing neuromuscular block induced by rocuronium.

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References

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Dexamethasone influence on the action of rocuronium bromide: a randomized controlled trial

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Dexamethasone influence on the action of rocuronium bromide: a randomized controlled trial

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