Effects of sevoflurane, desflurane or propofolanesthesıa on hıgh dose rocuronıum ın laparoscopıc cholecystectomy operatıons

The aim of this study was to evaluate the effects of sevoflurane, desflurane, and propofol anesthesia on the duration of neuromuscular blockade caused by a high dose of rocuronium in laparoscopic cholecystectomy procedures. Rocuronium, a non-depolarizing neuromuscular blocking agent, is frequently administered at a dose of 1.2 mg/kg to achieve deep neuromuscular block that allows laparoscopic surgery to be performed under lower intra-abdominal pressures without compromising surgical conditions. The first objective of the study was to determine whether the choice of anesthetic maintenance agent altered the duration of rocuronium’s effect. Seventy-five adult patients aged 18 to 65 years, classified as ASA I–III and scheduled for elective laparoscopic cholecystectomy, were enrolled. Patients were randomized into three groups. All patients received rocuronium at 1.2 mg/kg. In Group P, propofol was infused intravenously at 6–12 mg/kg/min. In Group D, desflurane was administered, while in Group S, sevoflurane was given, both inhaled at a minimum alveolar concentration (MAC) of 1–1.5. BIS values were maintained between 40–50. Intraoperative monitoring included train-of-four (TOF) and post-tetanic count (PTC). No significant differences were observed between the groups regarding demographic and hemodynamic characteristics, rocuronium and sugammadex doses, duration of operation, extubation and recovery times, or postoperative nausea and vomiting. The groups were also similar in terms of surgical satisfaction and time to first defecation. However, a significant difference was identified in the time to TOF = 1 and PTC = 1, which were longest in the desflurane group compared to sevoflurane and propofol. This indicated that desflurane significantly prolonged the neuromuscular blocking effect of rocuronium.