Determining the effect of long-term dexamethasone and prednisolone treatment on sugammadex

Abstract

Background/aim: We aimed to investigate the effect of long-term use of dexamethasone and prednisolone on the reversal effect ofsugammadex.Materials and methods: TTwenty-four male Wistar albino rats were divided into three groups. Dexamethasone (600 µg/kg) was given togroup D, prednisolone (10 mg/kg) was given to group P, and an equivalent volume of saline per day was administered intraperitoneally togroup S for 14 days, respectively. The left hemidiaphragm with attached phrenic nerve was maintained in Krebs solution. Sugammadex(30 µmol/L) was applied while rocuronium (10 µmol/L) was present in an organ bath and a single twitch was obtained. The righthemidiaphragm was used for both adult (ɛ-subunit) and fetal nicotinic acetylcholine receptor (AChR) (ɣ-subunit) determination usingpolymerase chain reaction.Results: All animals lost weight, except group S. The mean baseline single-twitch tension was lower in both group D (14.4 ± 1.7 g) andgroup P (12.68 ± 0.05 g) than group S (16.8 ± 0.5 g) (P < 0.001). When sugammadex was added to the organ bath while rocuronium waspresent, the single twitch was measured to be lower in both group D (11.7 ± 0.7 g) and group P (11.5 ± 0.78 g) than group S (16.5 ± 0.24g) (P < 0.001). ɣ-AChR expression was higher in both dexamethasone and prednisolone than in saline.Conclusion: Long-term medication with dexamethasone and prednisolone caused muscle weakness, resistance to neuromuscularblockers, and upregulation of immature γ-AChR and reduced the neuromuscular reversal effect of sugammadex.