80 岁及以上患者的神经肌肉阻滞：一项前瞻性、对照研究。

Neuromuscular block in patients 80 years and older: a prospective, controlled study.

机构信息

CHU Brugmann, Université Libre de Bruxelles, 4 Place Van Gehuchten, 1020, Bruxelles, Belgium.

CHRU de Nancy, Rue du Morvan, 54511, Vandœuvre-lès-Nancy, France.

出版信息

BMC Anesthesiol. 2021 Sep 13;21(1):225. doi: 10.1186/s12871-021-01443-1.

DOI:10.1186/s12871-021-01443-1

PMID:34517841

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8436544/

Abstract

BACKGROUND

An increasing number of patients older than 80 years are undergoing anesthesia, but little information is available regarding pharmacodynamic effects of myorelaxants in this population. This study aims to compare the time course of rocuronium neuromuscular block in patients ≥ 80 years with those of younger adults.

METHODS

Under total intravenous anesthesia with propofol and sufentanil, time course of a bolus of rocuronium 0.6 mg/kg neuromuscular block was assessed with acceleromyography in patients ≥ 80 and in patients 20-50 years old. Onset time, clinical duration, duration until 90% and 100% recovery of baseline were determined.

RESULTS

Data from 32 patients were analyzed, 16 were ≥ 80 years and 16 were 20-50 years old. Demographic data are shown in Table 1. In the group ≥ 80, onset time was 190 s ± 46 s compared to 123 s ± 40 s in the group 20-50, P < 0.001 and the clinical duration was 52 [48-69.5] min and 36 [34-41] min, respectively, P < 0.001. Duration to 90% recovery of baseline was 77.5 [71-88.5] min and duration to 100% recovery of baseline was 91.2 [82.2-98] min in patients ≥ 80 years and the corresponding values in the patients 20-50 years old were 53.5 [49-55.5] min and 59.5 [56.5-70.25] min, respectively, P < 0.001.

CONCLUSION

Compared to younger adults rocuronium shifted in patients ≥ 80 years from a rapid onset, intermediate acting compound to a slower onset, long-acting compound.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT03551652 (29/05/2018).

摘要

背景

越来越多 80 岁以上的患者接受麻醉，但关于该人群肌松药药效动力学的信息有限。本研究旨在比较 80 岁以上患者与年轻成人患者罗库溴铵神经肌肉阻滞的时程。

方法

在丙泊酚和舒芬太尼全身静脉麻醉下，通过加速度肌描记法评估 80 岁以上和 20-50 岁患者罗库溴铵 0.6mg/kg 推注的神经肌肉阻滞时程。测定起效时间、临床持续时间、恢复至基线 90%和 100%的时间。

结果

共分析了 32 例患者的数据，16 例患者年龄≥80 岁，16 例患者年龄 20-50 岁。表 1 显示了患者的人口统计学数据。在≥80 岁组中，起效时间为 190s±46s，而 20-50 岁组为 123s±40s，P<0.001；临床持续时间分别为 52[48-69.5]min和 36[34-41]min，P<0.001。恢复至基线 90%的时间为 77.5[71-88.5]min，恢复至基线 100%的时间为 91.2[82.2-98]min，而 20-50 岁组患者的相应值为 53.5[49-55.5]min和 59.5[56.5-70.25]min，P<0.001。