Kocabas S, Yedicocuklu D, Askar F Z
Ege University, Faculty of Medicine, Department of Anaesthesiology and Reanimation, Izmir, Turkey.
Eur J Anaesthesiol. 2008 Nov;25(11):940-6. doi: 10.1017/S0265021508004717. Epub 2008 Jun 9.
The elderly represent a wide and increasing patient population and significant numbers of elderly patients have chronic renal disease. This study aimed to investigate the neuromuscular effects of 0.6 mg kg(-1) rocuronium under propofol anaesthesia in young adults and elderly patients with or without renal failure.
The neuromuscular effects of rocuronium 0.6 mg kg(-1) under propofol anaesthesia were investigated in 40 patients with renal failure undergoing arteriovenous shunt surgery, of whom 20 were young adults (18-50 yr) and 20 were elderly (>65 yr) and in 40 patients with normal renal function undergoing peripheral venous surgery, of whom 20 were young adults and 20 were elderly. Neuromuscular transmission was monitored using acceleromyography. The times to recovery of the twitch (T1) to 25%, 50%, 75% and 90% and of the train-of-four ratio to 70%, and the recovery index were recorded.
The times to recovery of the first twitch to 25%, 50%, 75% and 90% and train-of-four to 70% and recovery index were found to be prolonged in both young and elderly patients with renal failure compared to those with normal renal function (e.g. T1 25%: 58.4 +/- 20.2 and 80.1 +/- 23.7 min vs. 32.8 +/- 5.6 and 46.3 +/- 9.0 min, respectively) (P < 0.05). These parameters were also prolonged in the elderly when compared with young adults in both the renal failure and the non-renal failure groups.
The neuromuscular effects of 0.6 mg kg(-1) rocuronium under propofol anaesthesia were markedly prolonged in young and elderly renal failure patients compared to patients with normal renal function, and also in elderly patients with normal renal function compared with young adults.
老年患者群体庞大且不断增加，大量老年患者患有慢性肾病。本研究旨在探讨在丙泊酚麻醉下，0.6mg/kg罗库溴铵对有或无肾衰竭的年轻成人及老年患者的神经肌肉影响。
对40例接受动静脉分流手术的肾衰竭患者（其中20例为年轻成人[18 - 50岁]，20例为老年患者[>65岁]）以及40例接受外周静脉手术的肾功能正常患者（其中20例为年轻成人，20例为老年患者），研究丙泊酚麻醉下0.6mg/kg罗库溴铵的神经肌肉影响。使用加速度肌电图监测神经肌肉传递。记录单次颤搐（T1）恢复至25%、50%、75%和90%的时间，四个成串刺激比值恢复至70%的时间以及恢复指数。
与肾功能正常的患者相比，有肾衰竭的年轻和老年患者单次颤搐恢复至25%、50%、75%和90%以及四个成串刺激恢复至70%的时间和恢复指数均延长（例如，T1 25%：分别为58.4±20.2和80.1±23.7分钟，对比32.8±5.6和46.3±9.0分钟）（P<0.05）。在肾衰竭组和非肾衰竭组中，老年患者的这些参数与年轻成人相比也延长。
与肾功能正常的患者相比，在丙泊酚麻醉下，0.6mg/kg罗库溴铵对年轻和老年肾衰竭患者的神经肌肉影响明显延长，并且与年轻成人相比，肾功能正常的老年患者其神经肌肉影响也延长。
