The Effect of Rocuronium Dosage on Intubation Conditions in Liver Transplant Recipients

Introduction: Neuromuscular blockers (NMB) play an important role in improving conditions in orthotopic liver transplantation (OLT).Depending on clinical conditions, diseases, and pharmacological interactions, the effective NMB dose for complete NMB varies.Our study investigated the effects of rocuronium used during rapid sequence intubation.The effects of this drug on onset of action and intubation conditions were studied in a control group and in an OLT patient group.Methods: The study is prospective, involving 90 patients over the age of 18.The 45 patients scheduled to undergo OLT were assigned to Group 1, while the 45 patients without liver dysfunction scheduled to undergo a 4-6-hour surgery under general anesthesia were assigned to Group 2. Groups were dosed with 1.2 mg/kg rocuronium based on ideal body weight, and the effect on the time to reach a train-of-four (TOF) value of zero (TOF 0), time to intubation scores, and hemodynamic parameters was evaluated. Results:The demographic data across the groups were comparable.No significant differences were observed between the groups concerning TOF 0 time (p=0.806),intubation times (p=0.987),and intubation scores (p=0.898).However, when evaluating OLT patients individually, a statistically significant correlation was found between TOF 0 time and Child score (p=0.029,p<0.05). Conclusion:In patients with end-stage liver disease undergoing OLT, administering rocuronium at a dosage of 1.2 mg/kg based on ideal body weight, during rapid sequence intubation results in sufficient intubation conditions.Furthermore, there were no delays noted in the onset of rocuronium's action.