Comparison Of Different Sex And Age With Rocuronium Muscle Relaxant

Background: Muscle relaxants application is the induction of anesthesia and intubation, the Department of Anesthesia an important link , But now commonly used to nondepolarizing muscle relaxants, which can cause bradycardia, bundles of muscle fiber contraction stomach hypertension, increased IOP, intracranial hypertension, and other side effects induced hyperkalemia can even inspire malignant hyperthermia, and other serious adverse reactions .Non-depolarizing muscle relaxants, almost all there is a slow-starting, strong role in the release of histamine and hemodynamic changes Defects .Rocuronium as a new-steroidal muscle relaxants, almost without histamine release, block autonomic Festival starting with the efficiency, timeliness, recovered quickly and rarely accumulation features. Rocuronium light cardiovascular effect, good stability, and highly specific, can cause heart rate increased slightly, hemodynamics small. Rocuronium Pharmacodynamics influenced by many factors, such as the administration of the dose, pre-injection, assistant drug, liver and kidney function, body weight, race, and therefore the analysis of various factors judgment rocuronium the impact of medication for clinical importance. The sex and age of rocuronium pharmacodynamics of the impact of domestic and foreign scholars have had such studies, However, the conclusion is not completely identical, in different age groups under gender of rocuronium pharmacodynamics change has not been reported.Objective: Observation of age and gender of rocuronium pharmacodynamics of the size and extent of Evaluation of the factors under the influence of rocuronium effect of the changes.Methods: Choice of general anesthesia in patients(ASA I～II) with 75 cases by age and administration divided into A, B and C group, group A,B TCI intermittent injection pump group, Group C manual intermittent infusion. group of A was young and middle-aged(25-59years) group B for the elderly (65-80years). the group of A and B was divided into two subgroups , group of A₁ is young and middle-aged men(n=15), group of A₂ is young and middle-aged women (n=15), B₁ for older male group (n = 15 cases), B₂ for older women (n = 15 cases) . Group C is young and middle-aged men (n = 15 ), Patients into the operating theater after the establishment of intravenous access, routine monitoring electrocardiogram, blood pressure, heart rate and pulse oximetry, using TOF-Watch SX(Organon Teknika ,Netherlands) acceleration instrument muscle relaxant monitoring, forearm cloth wrapped thenar muscle to maintain the skin temperature of not less than 32℃. 0.1mg.kg^-1 midazolam and propofol 0.5～1mg.kg^-1. 4-5μg.kg^-1 fentanyl intravenous anesthesia , Patients sleep after the correction started TOF-Watch CAL button button for muscle relaxants correction, At this time of the single-stimulated muscle twitch (T₁) to a height of 100% as a basis for value (Tc) ,Tc stability in 100%3-5 minutes later to give rocuronium , Group A and Group B with interesting applications Szenohradszkay pharmacokinetic model of TCI( company of silugao TCI-I Beijing) pump, for in rocuronium 0.6mg.kg^-1. TCI intravenous infusion. Group C using a single hand movement intravenous injection method for rocuronium 0.6mg.kg^-1 (injection time <5 seconds), When T₁ < 5% of base value, tracheal intubation mechanical ventilation . Anesthesia was maintained with propofol were 4～8mg.kg^-1.h^-1, remifentanil 0.05-0.1μg.kg^-1.min^-1 continuous intravenous infusion . When T₁ surgery to restore basic value by 25% in group A and group B to recover through TCI pump rocuronium bromide 0.15mg.kg^-1, and through TCI pump observation rocuronium in effect compartment concentration of target . Group C manually using intermittent intravenous injection delivery method . Acceleration through TOF-Watch SX devices and TCI pump monitoring rocuronium the onset time, peak time, Clinical time, recovery index, response time in vivo. The clinical time of the first recovery rocuronium(Ta) and muscle relaxants restored to 25% of the time rocuronium effect Room target concentration (Ce₁); The clinical time of the 2nd recovery rocuronium (Tb) and muscle relaxants restored to 25% of the time rocuronium effect Room target concentration (Ce₂); The clinical time of the 3rd recovery rocuronium (Tc) and muscle relaxants restored to 25% of the time rocuronium effect Room target concentration (Ce₃). And observing the intubation conditions.Results:1 Group A₁ and A₂ groups, B₁ and B₂ group, age, body mass index and potassium, sodium no significant difference (P> 0.05), total plasma protein comparison group A₁ than A₂ group, B₁ group than B₂, A₁ group than B₁, A₂ group than B₂ group (P <0.05); A₁ plasma albumin comparison group than in group A₂, A₁ group than in B₁ group Group A₂ than B₂ higher (P <0.05); B₁ and B₂ groups no significant difference (P> 0.05)2 Group A₁ and A₂ group compared onset times and peak hours, clinical role, in vivo time, useful difference was statistically significant (P <0.05), recovery index There was no significant difference (P> 0.05); B₁ and B₂ group compared onset times and the peak effect, shorten the time of clinical role, the difference was statistically significant (P <0.05), while the in vivo role, index resumed with no significant difference (P> 0.05). Compared with the young group, the older group sex with the onset time, peak time, clinical role, in vivo, The recovery index was significantly extended, the difference was statistically significant (P <0.05)3 Sex in old age group between efficacy parameters and the degree of discrepancy compared to the young group decreased4 Under the administration of the different ways to choose A₁ group C compared with the onset time, A₁ Group delivery time of 17±3s significantly longer than in group C 4±1s (P <0.05) ,onset time in group C 92±16s significantly faster than the group A₁ 124±17s. the difference was statistically significant (P <0.05)5 With the additional increase in the number of drugs, rocuronium in vivo clinical role of muscle relaxation time and returned to 25% of the time calculated effect Room target concentrations change . Group A₁ and A₂ Group with additional increase in the number of drugs in clinical duration and effects Room calculated target concentration without significant change, There was no significant difference (P> 0.05). B₁ and B₂ group with the additional increase in the number of drug clinical role significantly prolonged time, Effects Room drug concentration has been gradually declining, the difference was statistically significant (P <0.05)6 Tracheal intubation conditions : A₁ group, two cases of benign conditions for intubation, B₁ Group 1 intubation conditions for good, The remaining intubation conditions were excellent. A₁ group, which three cases maximal inhibition did not meet T/Tc to 0, A₂,B₁,B₂ group reached T/Tc to 0, A₁ and A₂ groups, B₁ and B₂ group there was no significant difference (P> 0.05)Conclusion:1 Gender and age may also lead to rocuronium Pharmacodynamics change; The major impact of gender performance in the women rocuronium muscular Songmin emotional increase. Elderly make rocuronium onset time, peak time, clinical role, and intimate time of recovery time extended2 Different age group sex on rocuronium pharmacodynamics of the degree of difference Sex in the young group of rocuronium pharmacodynamic effects, Sex increases with age caused rocuronium pharmacodynamic differences in the degree decreases3 With the additional increase in the number of drug and rocuronium in elderly patients will have accumulated4 Maintain the same level of the muscle relaxant needed to calculate the effect compartment concentration target young people than older groups5 Young and middle-aged men in the administration faster pace significantly shorten rocuronium the onset time, But other pharmacodynamics of no significant impact indicators...