Reduced clearance of rocuronium and sugammadex in patients with severe to end- stage renal failure: a pharmacokinetic study† L.M. Staals, M.M.J. Snoeck,

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Reduced clearance of rocuronium and sugammadex in patients with severe to end- stage renal failure: a pharmacokinetic study† L.M. Staals, M.M.J. Snoeck, J.J. Driessen, H.W. van Hamersvelt, E.A. Flockton, M.W. van den Heuvel, J.M. Hunter British Journal of Anaesthesia Volume 104, Issue 1, Pages 31-39 (January 2010) DOI: 10.1093/bja/aep340 Copyright © 2010 The Author(s) Terms and Conditions

Fig 1 Sugammadex plasma concentration vs time plots for patients with renal failure and control patients. (a) Median (range) sugammadex plasma concentration (µg ml–1) vs time (min), for time points up to 60 min after injection of sugammadex. (b) Semi-logarithmic plot: median (range) sugammadex plasma concentration (µg ml–1) vs time (h), for time points up to 48 h after injection of sugammadex. Plasma concentrations were below the limit of quantification after 8 h in the control group. The numbers (n) of samples at each time point are given for the renally impaired group. British Journal of Anaesthesia 2010 104, 31-39DOI: (10.1093/bja/aep340) Copyright © 2010 The Author(s) Terms and Conditions

Fig 2 Rocuronium plasma concentration vs time plots for patients with renal failure and control patients. (a) Median (range) rocuronium plasma concentration (ng ml–1) vs time (min) after administration of rocuronium and sugammadex, for time points up to 60 min after injection of sugammadex. (b) Semi-logarithmic plot: median (range) rocuronium plasma concentration vs time, for time points up to 48 h after administration of sugammadex. Plasma concentrations were below the lower limit of quantification after 18 h in the control group. The numbers (n) of samples at each time point are given for the renally impaired group. British Journal of Anaesthesia 2010 104, 31-39DOI: (10.1093/bja/aep340) Copyright © 2010 The Author(s) Terms and Conditions

Fig 3 Regression plots of total plasma clearance (CL) of sugammadex and rocuronium vs CLCR (creatinine clearance) in normal controls and patients with renal insufficiency not yet on dialysis. (a) Regression plot of sugammadex CL vs CLCR (r=0.72) and (b) rocuronium CL vs CLCR (r=0.60). British Journal of Anaesthesia 2010 104, 31-39DOI: (10.1093/bja/aep340) Copyright © 2010 The Author(s) Terms and Conditions