Adamus Milan, Hrabalek Lumir, Wanek Tomas, Gabrhelik Tomas, Zapletalova Jana
Department of Anesthesiology and Intensive Care Medicine, University Hospital Olomouc, Palacky University Olomouc, Czech Republic.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2011 Dec;155(4):347-53. doi: 10.55.07/bp.2011.050.
To compare the pharmacodynamics of 0.6 mg kg(-1) rocuronium in young and older patients of both genders during total intravenous anesthesia.
Following local ethics committee approval and informed consent, patients scheduled for surgery under total intravenous anesthesia (propofol/sufentanil) were divided into 4 study groups: 37 males aged 20-40, 40 males aged 60-75 yrs, 43 females aged 20-40 and 38 females aged 60-75 yrs. Neuromuscular block following rocuronium (0.6 mg kg(-1)) was monitored: train-of-four [TOF] stimulation of the ulnar nerve at 15-s intervals, EMG of the adductor pollicis muscle. The onset time (from application of rocuronium to maximum depression of T(1)), clinical duration (from application to 25% recovery of T(1)), and time to full spontaneous recovery (from application to TOF-ratio ≥ 0.9) were determined for each patient. The Kruskal-Wallis test was used to compare differences between groups; P<0.05 was considered statistically significant.
The onset time (median [interquartile range]) in the respective groups was 90 80-110, 135 116-165, 75 60-90, and 120 90-146 seconds. The clinical duration was 30 25-42, 58 53-67, 50 40-65, and 85 70-90 min. Interval to full spontaneous recovery was 59 51-67, 102 75-106, 76 66-91, and 128 94-137 min. ((A)P<0.05 vs. young males, (B)P<0.05 vs. elderly males, (C)P<0.05 vs. young females, (D)P<0.05 vs. elderly females).
Females and older patients were more sensitive to rocuronium.
比较在全静脉麻醉期间，0.6mg/kg的罗库溴铵在年轻和老年男性及女性患者中的药效学。
经当地伦理委员会批准并获得知情同意后，计划接受全静脉麻醉（丙泊酚/舒芬太尼）的患者被分为4个研究组：37名年龄在20 - 40岁的男性、40名年龄在60 - 75岁的男性、43名年龄在20 - 40岁的女性和38名年龄在60 - 75岁的女性。监测罗库溴铵（0.6mg/kg）给药后的神经肌肉阻滞情况：每隔15秒对尺神经进行四个成串刺激（TOF），同时监测拇收肌的肌电图。测定每位患者的起效时间（从给予罗库溴铵到T1最大抑制的时间）、临床作用时间（从给药到T1恢复25%的时间）以及完全自主恢复时间（从给药到TOF比值≥0.9的时间）。采用Kruskal - Wallis检验比较组间差异；P<0.05被认为具有统计学意义。
各研究组的起效时间（中位数[四分位间距]）分别为90[80 - 110]（BCD）、135[116 - 165]（AC）、75[60 - 90]（ABD）和120[90 - 146]（AC）秒。临床作用时间分别为30[25 - 42]（BCD）、58[53 - 67]（AD）、50[40 - 65]（AD）和85[70 - 90]（ABC）分钟。完全自主恢复时间分别为59[51 - 67]（BCD）、102[75 - 106]（A）、76[66 - 91]（AD）和128[94 - 137]（AC）分钟。（（A）与年轻男性相比P<0.05，（B）与老年男性相比P<0.05，（C）与年轻女性相比P<0.05，（D）与老年女性相比P<0.05）。
女性和老年患者对罗库溴铵更为敏感。
