The hepatotoxicity of rocuronium
The hepatotoxicity of many drugs is poorly screened for in human models, even though hepatotoxicity is an important cause of liver failure, say German researchers at the University Hospital of Rostock and the Fraunhofer Institute for Cell Therapy and Immunology. In particular, liver failure is a major problem in critically ill patients who often require tracheal intubation and rapid-sequence induction, which is performed with the use of rocuronium and succinylcholine as neuromuscular blocking agents. The present study investigated the hepatotoxicity of these two drugs in an in-vitro test on the permanent human liver cell line HepG2/C3A.
After two incubation periods of three days, the authors measured the viability of the cells (XTT test, lactate dehydrogenase release, trypan blue staining), the micro-albumin synthesis and the cytochrome 1A2 activity as a metabolism of ethoxyresorufin. In the next step, they used the Kruskal–Wallis one-way test and two-tailed Mann–Whitney U test to assess the differences between the two drugs. They found that rocuronium – but not succinylcholine – led to a significant dose-dependent decrease of viability, albumin synthesis and cytochrome 1A2 activity of test cells.
Rocuronium has a dose-dependent hepatotoxicity, conclude the authors. They now call for further studies to investigate the underlying mechanisms of the effects of rocuronium on hepatic cellular integrity.