{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T07:08:24Z","timestamp":1785308904310,"version":"3.55.0"},"reference-count":22,"publisher":"The Korean Society of Anesthesiologists","issue":"3","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["anesth-pain-med.org"],"crossmark-restriction":true},"short-container-title":["Anesth Pain Med"],"published-print":{"date-parts":[[2026,7,31]]},"abstract":"<jats:p>Background: This study utilized an ex-vivo model to examine the effect of respiratory acid-base balance on rocuronium-induced neuromuscular blockade and sugammadex-induced recovery and to assess the relationship between train-of-four (TOF) ratio and the first twitch tension of TOF (T1).Methods: After obtaining approval from the Asan Ethics Committee of the Laboratory of Animal Research, phrenic nerve-hemidiaphragm specimens were obtained from 30 adult Sprague-Dawley rats and randomly assigned to control (95% O2 + 5% CO2), respiratory alkalosis (97.5% O2 + 2.5% CO2), and acidosis (91% O2 + 9% CO2) groups, immersed in the Krebs\u2019 solution, and stimulated with TOF pattern at 20-s intervals. Rocuronium loading and booster doses were administered every 10 min until &gt; 95% blockade T1 was achieved. Recovery was monitored using T1 and TOF ratios (TOFR) until T1 to &gt; 95% and the TOFR to &gt; 0.9.Results: Left shift of the dose-response curve of T1% and TOFR occurred only in the acidosis group vs the alkalosis group (P &lt; 0.0001). The recovery progression of T1 and TOFR differed significantly between the groups (P = 0.0001). The total doses of rocuronium and sugammadex were different between the control and respiratory acidosis groups (P = 0.00318 and P = 0.00315, respectively), and between the respiratory acidosis and alkalosis groups (P = 0.0007 and P = 0.0007, respectively). Conclusions: Acid-base alterations due to CO2 changes may influence rocuronium-induced neuromuscular blockade and sugammadex-induced reversal. However, despite some inter-group differences, statistically discrete results were not obtained across the experimental groups.<\/jats:p>","DOI":"10.17085\/apm.25370","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:45:33Z","timestamp":1780533933000},"page":"391-399","update-policy":"https:\/\/doi.org\/10.17085\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of respiratory acid-base balance on rocuronium-induced neuromuscular blockade and sugammadex-induced reversal in rat phrenic nerve hemidiaphragm"],"prefix":"10.17085","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2369-6525","authenticated-orcid":true,"given":"Yong Beom","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8269-5058","authenticated-orcid":true,"given":"Chun 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