Dahaba Ashraf A, Perelman Seth I, Moskowitz David M, Bennett Henry L, Shander Aryeh, Xiao Zhaoyang, Huang Lin, An Gang, Bornemann Helmar, Wilfinger Georg, Hager Barbara, Rehak Peter H, List Werner F, Metzler Helfried
Department of Anaesthesiology and Intensive Care Medicine, Graz Medical University, Austria.
Anesthesiology. 2006 May;104(5):950-3. doi: 10.1097/00000542-200605000-00010.
Geographic location is not acknowledged as a stratifying factor that can directly affect drug potency, because drugs are still licensed with the same recommended dose for different geographic regions. The aim of the current study was to compare the potency and duration of action of rocuronium bromide in 54 patients in three countries with different life habits, diet, and ambient conditions, namely white Austrians, white North Americans, and Han Chinese in China.
Neuromuscular block of six consecutive 50-microg/kg rocuronium incremental doses followed by 300 microg/kg was evaluated using the Relaxometer mechanomyograph (Groningen University, Groningen, Holland). Dose-response curves were created using log-dose-probit transformation. The authors compared rocuronium bromide ED50, ED90, and ED95 (effective doses required for 50%, 90%, and 95% first twitch depression, respectively) as well as Dur25 and Dur0.8 (times from last incremental dose administration until 25% first twitch and 0.8 train-of-four ratio recovery, respectively) in patients of the three countries.
Rocuronium ED50, ED90, and ED95 were significantly higher in Austrian patients (258 +/- 68, 530 +/- 159, and 598 +/- 189 microg/kg) and Chinese patients (201 +/- 59, 413 +/- 107, and 475 +/- 155 microg/kg) compared with American patients (148 +/- 48, 316 +/- 116, and 362 +/- 149 microg/kg, respectively). Dur25 and Dur0.8 were significantly shorter in Austrian patients (22.3 +/- 5.5 and 36.9 +/- 12.8 min) and Chinese patients (30.4 +/- 7.5 and 45.7 +/- 15.9 min) compared with American patients (36.7 +/- 8.5 and 56.2 +/- 16.7 min, respectively).
The authors demonstrated a significant difference in rocuronium potency and duration of action among patients in the three countries. Larger studies are required for determining dosage recommendations for different geographic regions.
地理位置未被视为可直接影响药物效力的分层因素，因为不同地理区域的药物仍以相同的推荐剂量获批。本研究的目的是比较罗库溴铵在三个具有不同生活习惯、饮食和环境条件的国家（即奥地利白人、北美白人和中国汉族）的54例患者中的效力和作用持续时间。
使用Relaxometer肌动图仪（荷兰格罗宁根大学）评估连续6次50微克/千克罗库溴铵递增剂量（随后为300微克/千克）后的神经肌肉阻滞情况。使用对数剂量-概率转换创建剂量-反应曲线。作者比较了三个国家患者的罗库溴铵ED50、ED90和ED95（分别为产生50%、90%和95%首次颤搐抑制所需的有效剂量）以及Dur25和Dur0.8（分别为从最后一次递增剂量给药至首次颤搐恢复25%和四个成串刺激比值恢复至0.8的时间）。
与美国患者（分别为148±48、316±116和362±149微克/千克）相比，奥地利患者（258±68、530±159和598±189微克/千克）和中国患者（201±59、413±107和475±155微克/千克）的罗库溴铵ED50、ED90和ED95显著更高。与美国患者（分别为36.7±8.5和56.2±16.7分钟）相比，奥地利患者（22.3±5.5和36.9±12.8分钟）和中国患者（30.4±7.5和45.7±15.9分钟）的Dur25和Dur0.8显著更短。
作者证明了三个国家患者的罗库溴铵效力和作用持续时间存在显著差异。需要进行更大规模的研究以确定不同地理区域的剂量推荐。
