Journal Article

Reversal of profound rocuronium block monitored in three muscle groups with sugammadex in ponies

M. Mosing, U. Auer, D. Bardell, R. S. Jones and J. M. Hunter

in BJA: British Journal of Anaesthesia

Published on behalf of the British Journal of Anaesthesia

Volume 105, issue 4, pages 480-486
Published in print October 2010 | ISSN: 0007-0912
Published online July 2010 | e-ISSN: 1471-6771 | DOI:
Reversal of profound rocuronium block monitored in three muscle groups with sugammadex in ponies

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This clinical study evaluated the speed of reversal of profound rocuronium block in ponies using sugammadex and investigated the differences in onset and recovery from block in three different muscle groups.


Anaesthesia was induced and maintained with isoflurane in oxygen 100% in eight ponies. Neuromuscular monitoring was performed at each site using acceleromyography: in the extensor muscles of the pelvic limb (peroneal nerve) and thoracic limb (radial nerve), and in the orbicularis oris muscle (OOM; facial nerve). Rocuronium 0.6 mg kg−1 i.v. was administered, followed 5 min later by sugammadex 4 mg kg−1 i.v. Onset time (onsetROC), maximum block, and time to recovery of the train-of-four ratio to 0.9 (TOFR=0.9) were recorded. The differences between monitored sites were compared using one-way anova followed by a post hoc Dunn's test.


Onset of ROC was significantly delayed in OOM compared with both limbs [pelvic limb, thoracic limb, and OOM: 43.1 (sd 16.9), 50.6 (15.9), and 204.4 (35.8) s, respectively; P<0.001]. Complete block was achieved in the pelvic and thoracic limbs, but in none of the eight ponies in the OOM [mean T1=15.3 (9.4)%; range: 7–36%]. No differences were observed between muscle sites in recovery to TOFR=0.9 [pelvic limb, thoracic limb, and OOM: 2.3 (0.9), 3.4 (1.7), and 2.8 (2.1) min, respectively]. No adverse effects of sugammadex were detected throughout the study period.


Sugammadex can be used to reverse profound rocuronium-induced block in ponies during isoflurane anaesthesia. Thoracic limb muscles represent a suitable alternative for monitoring neuromuscular block compared with pelvic limb muscles.

Keywords: neuromuscular block; neuromuscular monitoring; pony; sugammadex; veterinary anaesthesia

Journal Article.  4425 words.  Illustrated.

Subjects: Anaesthetics

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