Influence of Age and Gender on the Pharmacodynamic Parameters of Rocuronium During Total Intravenous Anesthesia

Abstract

Aims.To compare the pharmacodynamics of 0.6 mg kg -1 rocuronium in young and older patients of both genders during total intravenous anesthesia.Methods. 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.Results.

Residual neuromuscular block in type II diabetes mellitus after rocuronium

“…Our control group had a DURTOF 90 consistent with that reported by other studies, considering mean age, anaesthetic procedure and rocuronium dose used. [11][12][13][14][15][16][17][18][19][20] Our results are also in agreement with Saitoh in the significantly longer times to reappearance of T1, T2, T3 and T4 in diabetic patients. 4-6 Saitoh also found a significantly lower TOF ratio at 120 min in the diabetic group.…”

Changes in duration of action of rocuronium following decrease in hepatic blood flow during pneumoperitoneum for laparoscopic gynaecological surgery

“…Among the 60 female patients, 30 underwent elective laparoscopic gynaecological surgery (group laparoscopy) and 30 underwent elective laparotomy gynaecological surgery (group control) concurrently. Considering the influence of age and body mass index (BMI) on the NMB of rocuronium [13, 14], subjects with age 35–60 years and with BMI 18.5 kg/m 2 –25 kg/m 2 were recruited. No patients were suffering from renal or hepatic disease, cardiovascular disease, diabetes, electrolyte disturbances, acid-base imbalances or neuromuscular disorders.…”

Peculiarities of Cisatracurium Application in Elderly Patients

“…Схожие результаты были получены и при использовании других ННМР [8]. Увеличение времени начала действия миорелаксантов также может быть связано со сниженным сердечным выбросом и низким кровотоком в мышцах у пациентов пожилого возраста [15].…”

“…Так, женщины на 20-30% более чувствительны к воздействию аминостероидных миорелаксантов [15]. Вероятно, это связано с более высоким со-держанием жира, низким процентом мышечной массы и воды у женщин, что приводит к мень-шему объему распределения миорелаксантов.…”

“…Кроме того, пол влияет и на их деградацию (печеночные микросомальные ферменты имеют различную активность у мужчин и женщин) и элиминацию (скорость клубочковой фильтра-ции и почечный клиренс у женщин ниже). В отличие от аминостероидных миорелаксантов, бензилизохинолиновые миорелаксанты (атра-куриум и цисатракуриум), по-видимому, не должны иметь существенных гендерных разли-чий [15]. В наше исследование было включено всего 6 мужчин, что связано с особенностями заболевания желчнокаменной болезнью.…”