• T Ezri, P Szmuk, R D Warters, R E Gebhard, E G Pivalizza, and J Katz.
• Department of Anesthesia Wolfson Medical Center, Holon, affiliated to the Sackler School of Medicine, Tel Aviv, Israel.
• Acta Anaesthesiol Scand. 2003 Oct 1; 47 (9): 1067-72.

BackgroundWe investigated the hypothesis that manipulation of cardiac output (CO) with esmolol (Es) or ephedrine (E) affects the onset time of rocuronium.MethodsFollowing anesthesia induction, 33 patients received E (70 micro g kg-1), Es (500 micro g kg-1) or placebo (P) 30 s before rocuronium (0.6 mg kg-1) administration. Cardiac output was measured non-invasively after intubation every 3 min. The interval from the end of rocuronium administration to the disappearance of all twitches was considered to be the onset time.ResultsOnset time was shorter after E (52.2 +/- 16.5 s) and longer after Es (114.3 +/- 11.1 s) compared with P (87.4 +/- 7.3 s) (P < 0.0001). Cardiac output increased (P < 0.05) in group E for 15 min after rocuronium. In group Es, CO decreased (P < 0.05) at 3 and 6 min. Cardiac output was higher in group E vs. group Es, 3-6 min post administration of rocuronium (P=0.015).ConclusionPretreatment with E or Es appears to affect the onset time of rocuronium by altering CO as measured with the NICO (Non-Invasive Cardiac Output) monitor (Novametrix Medical Systems Inc., Willingford, CO).

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