Collins L M, Bevan J C, Bevan D R, Villar G C, Kahwaji R, Smith M F, Donati F
Department of Anesthesia, Vancouver General Hospital Vancouver, British Columbia, Canada.
Anesth Analg. 2000 Dec;91(6):1526-30. doi: 10.1097/00000539-200012000-00042.
We compared the potency and duration of action of rocuronium in Chinese and Caucasian patients during general anesthesia. Thirty-six women (18 Caucasian and 18 Chinese) and 36 children (18 Caucasian and 18 Chinese) were evaluated during the administration of propofol/fentanyl anesthesia. Patients in each age group were randomized into three subgroups to receive single doses of 0.06, 0. 12, or 0.18 mg/kg rocuronium (adults) or 0.12, 0.18, or 0.24 mg/kg rocuronium (children). Neuromuscular blockade was assessed by electromyography of the adductor pollicis after train-of-four (TOF) stimulation of the ulnar nerve. Dose response curves were constructed when maximum neuromuscular depression of the first twitch of the train (T(1)) was obtained. A second bolus dose of rocuronium was then administered to a total dose of 0.6 mg/kg. The times of spontaneous recovery to T(1) 10%, 25%, and 90% of control and to TOF 0.25, 0.50, and 0.70 were recorded. For both adults and children, recovery occurred later in Chinese than in Caucasian patients (P<0.05 for T(1) of 10%, 25%, 75%, and 90% and TOF to 0.7). The 50% effective dose was smaller in Chinese adults (125+/-63 vs. 159+/-66 microg/kg) and Chinese children (171+/-43 vs. 191+/-46 microg/kg) than in Caucasian adults and children, but the difference was not statistically significant. In adults, time to 25% T(1) recovery was 43+/-13 min in Chinese patients and 33+/-10 min in Caucasian patients (P<0.05). The corresponding values were more rapid for children: 30+/-10 and 24+/-6 min (P<0.05). We conclude that the recovery from rocuronium neuromuscular blockade was longer in Chinese compared with Caucasian patients and in adults compared with children.
我们比较了罗库溴铵在全身麻醉期间对中国患者和白种患者的作用强度及持续时间。在丙泊酚/芬太尼麻醉过程中对36名女性（18名白种人和18名中国人）及36名儿童（18名白种人和18名中国人）进行了评估。每个年龄组的患者被随机分为三个亚组，分别接受单剂量0.06、0.12或0.18mg/kg罗库溴铵（成人）或0.12、0.18或0.24mg/kg罗库溴铵（儿童）。在对尺神经进行四个成串刺激（TOF）后，通过拇内收肌的肌电图评估神经肌肉阻滞情况。当获得成串刺激中第一个肌颤搐（T(1)）的最大神经肌肉抑制时，构建剂量反应曲线。然后给予第二次罗库溴铵推注剂量，使总剂量达到0.6mg/kg。记录自发恢复至对照值T(1)的10%、25%和90%以及TOF 0.25、0.50和0.70的时间。对于成人和儿童，中国患者的恢复时间均晚于白种患者（T(1)的10%、25%、75%和90%以及TOF至0.7时，P<0.05）。中国成人（125±63 vs. 159±66μg/kg）和中国儿童（171±43 vs. 191±46μg/kg）的50%有效剂量低于白种成人和儿童，但差异无统计学意义。在成人中，中国患者恢复至T(1)的25%的时间为43±13分钟，白种患者为33±10分钟（P<0.05）。儿童的相应数值恢复更快：分别为30±10和24±6分钟（P<0.05）。我们得出结论，与白种患者相比，罗库溴铵神经肌肉阻滞在中国患者中的恢复时间更长，且与儿童相比，成人的恢复时间更长。
