The effect of environmental tobacco smoke on the dose requirements of rocuronium in children

Paediatr Anaesth. 2004 Mar;14(3):247-50. doi: 10.1046/j.1460-9592.2003.01186.x.


Background: Smoking affects the pharmacodynamic and pharmacokinetic behaviour of several drugs. The aim of this study was to evaluate the effects of environmental tobacco smoke on onset and recovery time after single dose rocuronium in children.

Methods: Forty children between 4 and 10 years were enrolled into the study. Children who have no familial smoking history were included in the first group whereas passive smokers included in the second group. Sevoflurane in 50% O2 and 50% N2O was used for induction of anaesthesia. Evoked adductor pollicis electromyography was used to monitor neuromuscular block. The T95 and T25 values were recorded.

Results: The T95 values (+/-sd) for rocuronium were 110.1 +/- 39.3 s and 79.3 +/- 35.6 s for group 1 and group 2, respectively (P < 0.05). The T25 value of group 2 was 40.1 +/- 10.6 min and compared with group 1 values (30.85 +/- 7.02 min) it was significantly longer (P < 0.01).

Conclusion: This study shows that passive smoking children consume less rocuronium than nonsmokers during similar anaesthesia. We think that a history of passive smoking must also be taken into consideration during preoperative evaluation of paediatric patients.

MeSH terms

  • Androstanols / administration & dosage*
  • Anesthesia, General*
  • Child
  • Child, Preschool
  • Electromyography
  • Female
  • Humans
  • Male
  • Neuromuscular Blockade
  • Neuromuscular Nondepolarizing Agents / administration & dosage*
  • Rocuronium
  • Tobacco Smoke Pollution*


  • Androstanols
  • Neuromuscular Nondepolarizing Agents
  • Tobacco Smoke Pollution
  • Rocuronium