Department of Anesthesiology, Graduate School of Medical Sciences, Kumamoto University Hospital, Kumamoto University, 1-1-1 Honjyo, Cyuoku, Kumamoto-City, Kumamoto 860-8556, Japan.
Can J Anaesth. 2013 Jun;60(6):552-6. doi: 10.1007/s12630-013-9914-x. Epub 2013 Mar 6.
Administration of neuromuscular blocking agents using a dose calculated on actual body weight carries a risk of prolonged duration of action in obese patients whose body mass index (BMI) is > 30 kg · m(-2). In the present study, we hypothesized that there could be a correlation between BMI and the duration of action of rocuronium administered according to actual body weight in non-obese patients, in particular, overweight (BMI 25-30 kg · m(-2)) and underweight patients (BMI < 18.5 kg · m(-2)).
Sixteen female patients (BMI 15-30 kg · m(-2), aged 45-60 yr) scheduled for elective surgery under total intravenous anesthesia were included in this study. Rocuronium 0.9 mg · kg(-1) was administered, and adductor pollicis train-of-four responses following ulnar nerve stimulation were monitored every minute with acceleromyography. The times from the injection of rocuronium until spontaneous recovery of first twitch to 5% (5% Duration) and 25% (25% Duration) of baseline were measured, and the correlation with BMI was analyzed.
A significant correlation between 5% Duration and BMI (r(2) = 0.56; P < 0.001) was found by linear regression analysis. A significant correlation was also found between 25% Duration and BMI (r(2) = 0.49; P = 0.003).
In adult female patients with a BMI in the range of 15-30 kg · m(-2), the duration of action of rocuronium increases with BMI when the drug is administered on the basis of mg per actual kg body weight.
在肥胖患者（BMI＞30kg·m(-2)）中，根据实际体重计算给予神经肌肉阻滞剂可能会导致作用持续时间延长。在本研究中，我们假设，在非肥胖患者（特别是超重（BMI 25-30kg·m(-2)）和体重不足患者（BMI＜18.5kg·m(-2)）中，按实际体重给予罗库溴铵时，BMI 与罗库溴铵作用持续时间之间可能存在相关性。
本研究纳入 16 名女性患者（BMI 15-30kg·m(-2)，年龄 45-60 岁），拟在全静脉麻醉下接受择期手术。给予罗库溴铵 0.9mg·kg(-1)，通过加速度肌描记法监测尺神经刺激后拇内收肌的强直刺激 4 个成串反应。测量从罗库溴铵注射到第一个颤搐自发恢复至 5%（5%持续时间）和 25%（25%持续时间）基线的时间，并分析与 BMI 的相关性。
线性回归分析显示，5%持续时间与 BMI 之间存在显著相关性（r(2) = 0.56；P＜0.001）。25%持续时间与 BMI 之间也存在显著相关性（r(2) = 0.49；P = 0.003）。
在 BMI 范围为 15-30kg·m(-2)的成年女性患者中，按 mg/kg 实际体重给予罗库溴铵时，其作用持续时间随 BMI 增加而延长。
