Capuano Annalisa, Sullo Maria Giuseppa, Rafaniello Concetta, Sportiello Liberata, Fusco Pierfrancesco, De Vizia Macella, Ferraro Fausto
Department of Experimental Medicine, Section of Pharmacology, Pharmacoepidemiology and Pharmacovigilance Center of the Campania Region, Second University of Naples, Caserta, Italy.
Department of Anesthesia and Intensive Care, San Salvatore Hospital, L'Aquila, Italy.
J Pharmacol Pharmacother. 2015 Jul-Sep;6(3):175-8. doi: 10.4103/0976-500X.162012.
Rocuronium is a non-depolarizing neuromuscular blocking agent (NDNMBA), employed in the clinic as an adjunct to general anesthesia to facilitate tracheal intubation rapid sequence, and to provide skeletal muscle relaxation during surgery. Many cases of resistance to neuromuscular blocking agents (NMBAs) have been anecdotally reported. There are specific pathologic states, such as upper motor neuron lesions, severe thermal injuries, liver disease, renal failure, disuse atrophy, all of which show an increased resistance to the effects of nondepolarizing muscle relaxants. Also concurrent drug therapy can alter the efficacy of NMBAs such as some classes of antibiotics, furosemide, β receptor agonists, phosphodiesterase inhibitors, calcium antagonists, respiratory stimulants but also ketamine, propofol and barbiturates at high concentrations. In this scenario we describe an unusual case of 20-years-old man who showed a complete resistance to rocuronium maybe due to a glucocorticoids concomitant therapy.
罗库溴铵是一种非去极化神经肌肉阻滞剂（NDNMBA），在临床上用作全身麻醉的辅助药物，以促进快速顺序气管插管，并在手术期间提供骨骼肌松弛作用。已有许多关于对神经肌肉阻滞剂（NMBAs）耐药的病例报道。存在一些特定的病理状态，如上位运动神经元损伤、严重热损伤、肝脏疾病、肾衰竭、废用性萎缩，所有这些状态都显示出对非去极化肌肉松弛剂的作用耐药性增加。同时，药物治疗也会改变NMBAs的疗效，如某些类别的抗生素、呋塞米、β受体激动剂、磷酸二酯酶抑制剂、钙拮抗剂、呼吸兴奋剂，以及高浓度的氯胺酮、丙泊酚和巴比妥类药物。在这种情况下，我们描述了一名20岁男性的罕见病例，他可能由于同时接受糖皮质激素治疗而对罗库溴铵完全耐药。
