Choi Yoon-Ji, Hee Kim Yun, Bae Go Eun, Yu Joon Ho, Yoon Seung Zhoo, Kang Hee Won, Lee Kuen Su, Kim Jae-Hwan, Lee Yoon-Sook
1 Department of Anaesthesiology and Pain Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea.
2 Maypure Clinic, Uijeongbu, Republic of Korea.
J Int Med Res. 2019 Apr;47(4):1521-1532. doi: 10.1177/0300060518822197. Epub 2019 Feb 5.
The dose of neuromuscular blocking drugs is commonly based on body weight, but using muscle mass might be more effective. This study investigated the relationship between the effect of neuromuscular blocking drugs and muscle mass measured using bioelectrical impedance analysis.
Patients who were scheduled for elective surgery using a muscle relaxant were screened for inclusion in this study. Under intravenous anaesthesia, 12 mg or 9 mg of rocuronium was administered to males and females, respectively; and the maximal relaxation effect of T1 was measured using a TOF-Watch-SX® acceleromyograph.
This study enrolled 40 patients; 20 males and 20 females. For both sexes, the maximal relaxation effect of T1 did not correlate with the body weight-based dose of neuromuscular blocking drugs (males, r = 0.12; females, r = 0.26). Instead, it correlated with the dose based on bioelectrical impedance analysis-measured muscle mass when injected with the same dose of rocuronium (males, r = 0.78, female, r = 0.82).
This study showed that the muscle relaxation effect of rocuronium was correlated with muscle mass and did not correlate with body weight when using the same dose. Therefore, a muscle mass-based dose of neuromuscular blocking drugs is recommended.
神经肌肉阻滞药物的剂量通常基于体重，但使用肌肉量可能更有效。本研究调查了神经肌肉阻滞药物的效应与使用生物电阻抗分析测量的肌肉量之间的关系。
筛选计划使用肌肉松弛剂进行择期手术的患者纳入本研究。在静脉麻醉下，分别给男性和女性静脉注射12 mg或9 mg罗库溴铵；使用TOF-Watch-SX®加速度肌动描记器测量T1的最大松弛效应。
本研究共纳入40例患者，其中男性20例，女性20例。对于男女两性，T1的最大松弛效应与基于体重的神经肌肉阻滞药物剂量均无相关性（男性，r = 0.12；女性，r = 0.26）。相反，当注射相同剂量的罗库溴铵时，T1的最大松弛效应与基于生物电阻抗分析测量的肌肉量的剂量相关（男性，r = 0.78，女性，r = 0.82）。
本研究表明，使用相同剂量时，罗库溴铵的肌肉松弛效应与肌肉量相关，而与体重无关。因此，推荐基于肌肉量的神经肌肉阻滞药物剂量。
