Pharmacokinetics and pharmacodynamics of rocuronium in patients with and without renal failure

Reversal of rocuronium-induced neuromuscular block by sugammadex is independent of renal perfusion in anesthetized cats

“…Rocuronium is not dependent on renal blood flow for its major route of excretion, but is taken up by the liver and excreted into the bile in high concentrations [9]. Although hepatic uptake and biliary elimination are thought to be the main routes of elimination for rocuronium, it seems that renal failure can have a marked effect on rocuronium pharmacokinetics and pharmacodynamics, although not consistently so [16][17][18]. In patients with no or minimum renal function, the clinical duration and recovery time of rocuronium 0.6 mg/kg increased significantly [16][17][18].…”

Neuromuscular block and current treatment strategies for its reversal in children

“…Sugammadex has been used also in patients with end-stage renal failure (114). Even though elimination kinetics of rocuronium is known to be prolonged in renal failure (115), the study could not find any difference of reversal characteristics between the patients with end-stage renal failure and those with normal renal function (114). When sugammadex 2 mgAEkg )1 was administered at the reappearance of the second twitch response, it took 2.0 ± 0.7 and 1.7 ± 0.6 min, respectively, to attain a TOF ratio of 0.90.…”

Should Dosing of Rocuronium in Obese Patients Be Based on Ideal or Corrected Body Weight?

“…We estimated a 10 min sd for time to reappearance of T4 based on two previous studies. 1,13 We considered a difference in time to reappearance of T4 of 10 min between the IBW and CBW40% groups to be clinically relevant. We calculated that a sample size of 17 patients in each group would allow us to detect this difference, with 5% Type 1 error risk, 80% power, and 10% dropout.…”