Hu Zhenhua, Li Benmu, Li Zhanwen, Liu Zhe, Liu Shengqun
Department of Anesthesia and Perioperative Medicine, Henan Provincial People's Hospital, Zhengzhou, Henan, China.
Department of Sports Medicine and Nutrition, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States.
Front Med (Lausanne). 2024 May 30;11:1399475. doi: 10.3389/fmed.2024.1399475. eCollection 2024.
This study aimed to investigate the dose-response relationship of rocuronium administered based on skeletal muscle weight and to assess the feasibility of calculating rocuronium dosage by skeletal muscle weight in short surgeries for patients with obesity. This single-center, randomized controlled clinical trial included 71 patients with obesity aged 28-70 years, with body fat percentages (PBF) >20% in men and > 28% in women, ASA status I-III, scheduled for tracheoscopy. Patients were randomly allocated into two groups: skeletal muscle group (SM group) received rocuronium based on the skeletal muscle content (1.0 mg/kg, = 31), and the conventional administration group (conventional group) received rocuronium based on total body weight (0.45 mg/kg, = 30). General anesthesia was administered using the same protocol. Parameters recorded included patients' general condition, muscle relaxant usage, onset time of muscle relaxants, non-response time, clinical effect time, 75% recovery time, and recovery index. Additionally, occurrences of body movement, choking, and incomplete muscle relaxation during surgery were recorded. Compared to the conventional group, the SM group required significantly less rocuronium dosage, resulting in significantly lower non-response time, clinical effect time, 75% recovery time, and recovery index ( < 0.05), and the onset time is slightly longer. Neither group experienced body movement, choking, or incomplete muscle relaxation ( > 0.05). Utilizing skeletal muscle weight to calculate rocuronium dosage in short surgeries for patients with obesity can reduce dosage, shorten recovery time, and prevent residual muscle relaxation while achieving satisfactory muscle relaxation to meet surgical requirements.
本研究旨在探讨根据骨骼肌重量给予罗库溴铵的剂量-反应关系，并评估在肥胖患者的短小手术中根据骨骼肌重量计算罗库溴铵剂量的可行性。这项单中心随机对照临床试验纳入了71例年龄在28至70岁之间的肥胖患者，男性体脂百分比（PBF）>20%，女性>28%，ASA分级为I-III级，计划进行气管镜检查。患者被随机分为两组：骨骼肌组（SM组）根据骨骼肌含量给予罗库溴铵（1.0mg/kg，n=31），传统给药组（传统组）根据总体重给予罗库溴铵（0.45mg/kg，n=30）。采用相同方案实施全身麻醉。记录的参数包括患者的一般情况、肌肉松弛剂使用情况、肌肉松弛剂起效时间、无反应时间、临床效应时间、75%恢复时间和恢复指数。此外，记录手术期间身体移动、呛咳和肌肉松弛不全的发生情况。与传统组相比，SM组所需的罗库溴铵剂量显著减少，导致无反应时间、临床效应时间、75%恢复时间和恢复指数显著降低（P<0.05），且起效时间稍长。两组均未出现身体移动、呛咳或肌肉松弛不全（P>0.05）。在肥胖患者的短小手术中利用骨骼肌重量计算罗库溴铵剂量可减少剂量、缩短恢复时间并防止肌肉松弛残留，同时实现令人满意的肌肉松弛以满足手术要求。
