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British Journal of Anaesthesia, Vol 80, Issue 3 386-388, Copyright © 1998 by The Board of Management and Trustees of the British Journal of Anaesthesia

CASE REPORT

Accelerated recovery and disposition from rocuronium in an end-stage renal failure patient on chronic anticonvulsant therapy with sodium valproate and primidone

J. J. Driessen, E. N. Robertson, LHDJ. Booij and T. B. Vree
Department of Anaesthesiology, Academic Hospital Nijmegen Sint Radboud, Geert Grooteplein 10, PO Box 9101, 6500 HB Nijmegen, The Netherlands

An end-stage renal failure patient, receiving chronic treatment with the anticonvulsants, sodium valproate and primidone, showed accelerated recovery with enhanced elimination (T1/2(z) = 52 min) and clearance (Cl = 14.4 ml min-1 kg-1) of rocuronium. The pharmacokinetic and pharmacodynamic effects of rocuronium in this patient are compared with those published for healthy and renal failure patients. Increased hepatic binding of rocuronium rather than metabolism is suggested as the possible cause of this effect.
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