Influences Of Age On Dose-response Relationship And Recovery Time-course Of Cisatracurium

Objective1,To evaluate the influence of age on pharmacodynamics of cisatracurium.2,To investigate the dose-response relationship and recovery time-course of cisatracurium in children aged 1 to 24 monthes.MethodsNinty patients,ASA gradeⅠ～Ⅱ,aged 1 month～59 years,scheduled for elective surgery,were included in the study.All patients were divided into three groups according to their ages:Groupâ… :30 patients aged 16～59 years;Groupâ…¡:30 patients aged 2～12 years;Groupâ…¢:aged 1～24 monthes.General anesthesia was induced and maintained with midazolam-propofol-fentanyl.Neuromuscular function was assessed by train-of-four(TOF)stimulation of accelerometry and the percentage depression of the first response(T₁)of the TOF stimulus was used as the study parameter.Patients in esch group were randomly allocated to receive one of three cisatracurium doses(30,40,50μg/kg)followed by a second supplemental dose to reach a total dose of 100μg/kg.we compared cisatracurium dose-response relationship and time Course of action among three groups.Results 1,The value of ED₉₅is larger in older people.the value of ED₉₅is 0.05929 mg/kg in Groupâ… ,0.05588 mg/kg in Groupâ…¡and 0.04539 mg/kg in Groupâ…¢.there is significant difference in the dose-response relationship comparing Groupâ…¢to Groupâ… and Groupâ…¡respectively,the 95%confidence intervals of relative median potency are 1.20762～1.42948,0.74560～0.87699,not including 1.while there is no significant difference between Groupâ… and Groupâ…¡,the 95% confidence intervals of relative median potency is 0.99201～1.13786, including 1.2,There were significant differreces of recovery-time course of cisatracurium among Groupâ… ,â…¡,â…¢.Cpmpare to Groupâ…¡,the peak effect duration,clinial duration and total duration of cisatracurium in Groupâ… were longer(P＜0.05),but these were shorter than Groupâ…¢(P＜0.05);There were no significant differences in recovery index among three groups(P＞0.05).Conclusion1,The dose of cisatracurium is increasing following age adding to get the same degree of muscle relaxation.Yet there is no difference in the degree of muscle relaxation between adults and children who are older than 2 years when giving the same doses of cisatracurium;while it is significant less dose in children aged 1 to 24 monthes to get the same degree of muscle relaxation as people who is older than 2 years. 2,The recovery time of muscle relaxation is longer following age adding for people who are older than 2 years.Comparing to them,the recovery time-course of cisatracurium in children aged 1 to 24 monthes is longest.when the muscle strength begin to recover spontaneously,the subside of cisatracurium was identical in different age ranges.