Effect of intraoperative warming on recovery and antagonism of rocuronium-induced residual neuromuscular blockade

Objective To investigate the effects of intraoperative warming on the recovery from rocuronium-induced postoperative residual neuromuscular blockade and the antagonism effect of small dose of neostigmine.Methods Forty patients receiving elective surgery were randomly divided into four groups:groupⅠ,without warming and allowing spontaneous recovery of rocuronium-induced neuromuscular blockade;group Ⅱ,warming and allowing spontaneous recovery;group Ⅲ,without warming,but the residual neuromuscular blockade was antagonized with small dose of neostigmine;and group Ⅳ,warming and antagonized with small dose of neostigmine(n=10 each).General anesthesia was induced with propofol,fentanyl and rocuronium 0.6 mg/kg.The neuromuscular transmission was monitored by train-of-four(TOF)-Watch SX acceleromyograph.Rocuronium was given when T1 recovered to 0.25.Patients were covered and electric blanket was used for warming group.The residual neuromuscular blockade was antagonized with atropine(0.5 mg)and neostigmine(0.015 mg/kg)in the antagonism group when the train-of-four ratio(TOFR)reaching 0.6.The intervals of TOFR recovering from 0.6 to 0.9 were recorded.Results After operation,the body temperature of group Ⅲ and Ⅳ was significantly higher than those of the other two groups(all P0.05).The TOFR recovery interval was(15.5±2.6)min in Ⅳ group,which was significantly shorter than that in group Ⅱ(6.3±2.0)min(P0.05);significant difference was also found in the recovery intervals between group Ⅱ and Ⅳ([15.5±2.6] min vs.[19.5±6.3] min,P0.05).The recovery in antagonizing groups was much faster than those in the spontaneous groups(P0.01).Conclusion Intraoperative warming is favorable for spontaneous recovery and antagonizing from postoperative rocuronium-induced neuromuscular blockade.