Lauri Pautola, M. Reinikainen
2012
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Journal
Duodecim; laaketieteellinen aikakauskirja
Abstract
Rocuronium bromide is a muscle relaxant used in general anesthesia, inhibiting cholinergic neurotransmission of neuromuscular junction. Donepezil used for the treatment of Alzheimer's disease inhibits decomposition of acetylcholine. We describe a case in which donepezil most obviously weakened the muscle relaxation induced by rocuronium. Because the interaction may impair intubation and surgery conditions, anesthesiologists should be aware of it. Prior to general anesthesia, a 2-4-week pause in anticholinesterase medication has been recommended. So far, reliable scientific data on the subject is lacking.