Resistance to non-depolarizing neuromuscular blocking agents

The authors experienced three cases of the resistance to the nondepolarizing neuromuscular blocking agents (NMBAs), rocuronium. There are many factors that affect NMBAs such as steroid, endocrine or autoimmune diseases which are thyroid disease, parathyroid disease, myasthenia gravis and etc., and anticonvulsant medication. However, in these three cases, the patients did not have any neuromuscular disorder, except certain drug administration, smoking, endocrine disorder and fever. In this study, we report three cases of the resistance to rocuronium where the resistance duration was much shorter than known and we should be aware of the importance of neuromuscular monitoring.