Pharmacodynamics of rocuronium in sickle cell patients

Anaesth Crit Care Pain Med. 2022 Feb;41(1):101011. doi: 10.1016/j.accpm.2021.101011. Epub 2021 Dec 16.


Background: Sickle cell disease is the most widespread genetic disease in the world. The chronic organ damage due to this disease could lead to variability of responses to the anaesthetic drugs. We analysed the pharmacodynamics response of rocuronium to sickle cell patients.

Methods: We observed and compared the onset time and clinical duration (time to recovery first twitch) of 0.6 mg kg-1 of rocuronium using a TOFscan® monitor, as well as the time before the first incremental dose (time to recovery second twitch), in a group of 22 homozygous sickle cell patients and a group of 23 controls, all programmed for laparoscopic surgical procedures.

Results: The onset time of rocuronium was longer in sickle cell patients [mean ± SD (extremes)], [6.3 ± 2.1 (1.8-10) min] than in the control group [2.5 ± 0.6 (1.4-3.5) min] (P < 0.01). The clinical duration was shorter in sickle cell patients [19.2 ± 7.1 (13-41) min] when compared to the control group [28.9 ± 6.9 (21-48) min] (P < 0.01). The time before the first incremental dose was shorter in the sickle cell patients group [27.7 ± 7.9 (19-49) min] compared to the control group [39.9 ± 8.7 (30-56) min] (P < 0.01).

Conclusion: The onset time of rocuronium was significantly longer with a shorter duration of action in patients with sickle cell disease versus the general population.

Keywords: Anaesthesia; Laparoscopic surgery; Pharmacodynamics; Rocuronium; Sickle cell-disease.

MeSH terms

  • Androstanols / pharmacology
  • Anemia, Sickle Cell* / drug therapy
  • Humans
  • Neuromuscular Nondepolarizing Agents* / pharmacology
  • Rocuronium
  • Time Factors


  • Androstanols
  • Neuromuscular Nondepolarizing Agents
  • Rocuronium