Steinberg D
Departamento de Anestesia, Hospital Clínicas Caracas, Policlínica Méndez Gimón, Caracas, Venezuela.
Rev Esp Anestesiol Reanim. 2009 Dec;56(10):604-11. doi: 10.1016/s0034-9356(09)70476-1.
The correlation between gender and the potency of certain neuromuscular blockers, including rocuronium, has been investigated. However, the methods used have been inconsistent. This study aimed to look further at the role of gender in order to arrive at definitive conclusions.
In a first and second phases of the study, rocuronium dose-response curves were constructed for patient groups as follows: 2 mixed-gender groups, 2 female groups, and 2 male groups. One group in each set received a single dose. In the other group the effect of the accumulated dose was measured after each of 3 fractions. The doses were transformed logarithmically. The effect was monitored by electromyography, and probit analysis was used to calculate the effective dose to induce 50%, 90% and 95% of the maximum effect (ED50, ED90 and ED95, respectively) in each patient. In the third phase, a bolus dose of 400 microg-Kg(-1) was administered to 3 additional groups. Onset time, maximum effect, speed of onset, duration of effect as the 10%-25% recovery index, and speed of recovery were recorded. In the fourth phase analysis was restricted to measurements during the period of onset.
No significant between-group differences in mean (SD) ED50, ED90, or ED95 values were observed after single doses (female group: 176 [68], 252 [97], and 285 [110] microg x Kg(-1), respectively; male group: 187 [69], 271 [100], and 307 [114] microg x Kg(-1); mixed group: 172 [73], 233 [98], and 258 [109] microg x Kg(-1)). Assessment of effect after cumulative fracional doses gave the following mean values for ED50, ED90, and ED95: 249 (63), 310 (79), and 334 (85) microg x Kg(-1) for the female group; 261 (60), 327 (75), and 354 (81) microg x Kg(-1) for the male group; and 242 (70), 305 (88), and 330 (95) microg x Kg(-1) for the mixed group. No significant differences in measures of effect were found after bolus administration in the third phase.
These results suggest that there is no significant effect of gender on potency or course of action of rocuronium bromide. Reports of such differences based on previous studies may be the result of problems in the methods applied.
已对性别与某些神经肌肉阻滞剂（包括罗库溴铵）效能之间的相关性进行了研究。然而，所采用的方法并不一致。本研究旨在进一步探讨性别所起的作用，以便得出明确结论。
在研究的第一阶段和第二阶段，为以下患者组构建罗库溴铵剂量 - 反应曲线：2个混合性别组、2个女性组和2个男性组。每组中的一组接受单次剂量。另一组在3次分次给药的每次给药后测量累积剂量的效果。剂量进行对数转换。通过肌电图监测效果，并使用概率分析计算每位患者诱导最大效应的50%、90%和95%（分别为ED50、ED90和ED95）的有效剂量。在第三阶段，给另外3组给予400μg·kg⁻¹的单次推注剂量。记录起效时间、最大效应、起效速度、作为10% - 25%恢复指数的效应持续时间以及恢复速度。在第四阶段，分析仅限于起效期间的测量。
单次给药后，各性别组之间在平均（标准差）ED50、ED90或ED95值方面未观察到显著差异（女性组分别为：176 [68]、252 [97]和285 [110]μg·kg⁻¹；男性组：187 [69]、271 [100]和307 [114]μg·kg⁻¹；混合组：172 [73]、233 [98]和258 [109]μg·kg⁻¹）。累积分次给药后效应评估得出ED50、ED90和ED95的以下平均值：女性组为249（63）、310（79）和334（85）μg·kg⁻¹；男性组为261（60）、327（75）和354（81）μg·kg⁻¹；混合组为242（70）、305（88）和330（95）μg·kg⁻¹。在第三阶段单次推注给药后，在效应测量方面未发现显著差异。
这些结果表明，性别对溴化罗库溴铵的效能或作用过程没有显著影响。基于先前研究的此类差异报告可能是所应用方法存在问题的结果。
