Correspondence  |   November 2017
Rocuronium Onset May Affect Mask Ventilation
Author Notes
  • Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (L.W.). weilx3934@sina.com
  • (Accepted for publication July 5, 2017.)
    (Accepted for publication July 5, 2017.)×
Article Information
Correspondence
Correspondence   |   November 2017
Rocuronium Onset May Affect Mask Ventilation
Anesthesiology 11 2017, Vol.127, 896-897. doi:10.1097/ALN.0000000000001827
Anesthesiology 11 2017, Vol.127, 896-897. doi:10.1097/ALN.0000000000001827
With great interest, we read the article by Sato et al.,1  which reports the influences of obstructive sleep apnea on mask ventilation during induction of general anesthesia by comparing patients with or without sleep-disordered breathing.In addition to the limitations described in the discussion, we note other issues that may have influenced their findings, and the determination of how much of the difference of mask ventilation was caused by obstructive sleep apnea. Specifically, factors influencing the onset time of rocuronium could affect mask ventilation, and these factors were not clearly described.
First, the exact peripheral intravenous sites of rocuronium administration were not described. The onset time of succinylcholine is closely related to drug transit time from the peripheral to the central circulation,2  and rocuronium has a similar onset time to succinylcholine.3  For vecuronium, administration into the pulmonary artery shortened the onset time by approximately 40 s compared with a dorsal vein of the hand.4  Different intravenous sites of rocuronium may produce different onset times. Therefore, the intravenous sites should be similar in the two groups in order to avoid potential bias.
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