Laparoscopic partial nephrectomy in a patient on simvastatin : Delayed recovery from neuromuscular blockade.

Laparoscopic partial nephrectomy in a patient on simvastatin : Delayed recovery from neuromuscular blockade. Anaesthesist. 2017 Mar 06;: Authors: Abd El-Hakeem EE, Kaki AM, Almazlom SA, Alsayyad AJ Abstract Delayed recovery from anesthesia remains a very challenging subject for anesthesiologists. This case report describes the clinical course of delayed recovery from neuromuscular blockade after laparoscopic partial nephrectomy in a patient on simvastatin. The patient was hypertensive on regular treatment with oral captopril 25 mg twice daily and amlodipine 5 mg once daily and hypercholesterolemic on regular simvastatin 40 mg once daily with a normal electrocardiogram (ECG). All preoperative laboratory findings were within normal ranges. The patient was premedicated with midazolam 1 mg and general anesthesia was induced with fentanyl 2 µg/kg body weight, propofol 2 mg/kg and rocuronium bromide 0.6 mg/kg to facilitate tracheal intubation. Anesthesia was maintained with inhalation of isoflurane 1.0-1.5 % in 40 % oxygen-enriched air and 25 µg boluses of fentanyl. The patient did not require any additional rocuronium throughout surgery which was finished after 4 h. The patient most probably had preoperative simvastatin-induced myotoxicity. This potentiated the muscle relaxant effect of rocuronium bromide and was the reason for patient unresponsiveness and delayed postoperative recovery. We can conclude that anes...
Source: Der Anaesthesist - Category: Anesthesiology Authors: Tags: Anaesthesist Source Type: research