| Part one:Effects of sevoflurane on the neuromuscular block induced by rocuronium in female or male patients.Objective:This study was done to determine the differences of time-course of neuromuscular block induced by rocuronium between women and men, and to evaluate the effects of sevoflurane on the enhancement of neuromuscular block caused by rocuronium in different genderMethods:120 patients (60 males and 60 females, ASAⅠ-Ⅱ), aged 20-60 yrs for elective surgery were studied. Based on different gender, they were randomly divided into propofol group (group P) and sevoflurane group (group S) (n=30 each). Midazolam, propofol and fentanyl were administrated intravenously during induction, and laryngeal mask was inserted after patients lost their consciousness. Anesthesia was maintained with propofol 6～10mg/kg.h in group P. And after 5min propofol infusing, rocuronium 0.6mg/kg was given intravenously. In group S, anesthesia was maintained with 1MAC of sevoflurane(end-tidal concentration 1.71%). The same dose of rocuronium was given intravenously. Neuromuscular function was assessed by accelerography. TOF stimulation of ulnar nerve was used. The onset time, recovery time of first twitch (T1), recovery time of T1 25% and recovery time of TOFR 25% were recorded.Results:Data for ROC suggests:in group P, the onset time of rocuronium in female patients was shorter than that in male patients, while recovery times of first twitch (T1), T1 25% and TOFR25% in female patients were longer than those in male patients (P<0.05). In addition, recovery time of TOFR 25% in women of group S was longer than that in women of group P (P<0.05). The onset time of rocuronium in male patients of group S was shorter than that in male patients of group P (P< 0.05). However, recovery times of first twitch (T1), T1 25% and TOFR25% in male patients of group S were longer than those in male patients of group P (P<0.05) Besides, in two sevoflurane groups, recovery times of T1 25% and TOFR 25% in male patients were longer than those in female patients (P<0.05)Conclusion: Females were more sensitive to a single bolus dose of rocuronium than males. The onset time in women was shorter than that in men, and the duration of rocuronium in female was prolonged compared with the vaule in men. The enhanced effect of sevoflurane on rocuronium-induced neuromuscular block in male was more evident than that in female.Part two:Effects of sevoflurane on the neuromuscular block induced by cisatracurium in female or male patients.Objective:This study was done to determine the differences of time-course of neuromuscular block induced by cisatracurium between women and men, and to evaluate the effects of sevoflurane on the enhancement of neuromuscular block caused by cisatracurium in different gender.Methods:120 patients (60 males and 60 females, ASAⅠ-Ⅱ), aged 20-60 yrs for elective surgery were studied. Based on different gender, they were randomly divided into propofol group (group P) and sevoflurane group (group S) (n=30 each). Midazolam, propofol and fentanyl were administrated intravenously during induction, and laryngeal mask was inserted after patients lost their consciousness. Anesthesia was maintained with propofol 6-10mg/kg.h in group P. And after 5min propofol infusing, cisatracurium 0.15 mg/kg was given intravenously. In group S, anesthesia was maintained with 1MAC of sevoflurane (end-tidal concentration 1.71%). The same dose of cisatracurium was given intravenously. Neuromuscular function was assessed by accelerography. TOF stimulation of ulnar nerve was used. The onset time, recovery time of first twitch (T1), recovery time of T1 25% and recovery time of TOFR 25% were recorded.Results:Data for CIS suggests:in group P, the onset time of cisatracurium in female patients was shorter than that in male patients, while recovery times of first twitch (T1), T1 25% and TOFR25% were not statistical differences between female and male patients (P>0.05). In addition, recovery times of first twitch (T1), T1 25% and TOFR25% in women of group S were longer than those in women of group P (P< 0.001), and so that the case between man of group S and group P (P<0.001). Besides, in group S, onset time of cisatracurium in female patients was shorter than that in male patients (P<0.001). However, recovery times of first twitch(T1), T1 25% and TOFR25% were not statistical differences between female and male patients (P> 0.05).Conclusion:The onset time of cisatracurium in women was shorter than that in men. However, there was no statistical significance in the duration of cisatracurium between female and male. There was no statistical difference in the enhanced effect of sevoflurane on cisatracurium-induced neuromuscular block between female and male.Part three:Effects of cisatracurium at room temperature for different time on the course of neuromuscular block.Objective:We compared the effects of cisatracurium at room temperature on the course of neuromuscular blockade.Methods:Patients undergoing elective abdominal surgery with general anesthesia were randomly assigned into one of four groups (n=15 each). In groupⅠ, cisatracurium was kept in room temperature (22-24℃) for 4 hours. In groupⅡ, cisatracurium was diluted two times with 0.9% sodium chloride, then it was kept in room temperature for 4 hours. In groupⅢ, cisatracurium was kept in room temperature for 12 hours.In groupⅣcontrol group, cisatracurium was kept in fridge at 2-8℃before using. Anesthesia was induced with midazolam 0.05mg/kg, fentanyl 1～2μg/kg and propofol 1～1.5mg/kg intravenously. Laryngeal mask was inserted after cisatracurium 0.15 mg/ kg. Anesthesia was maintained with propofol 6-10mg/kg. h. Neuromuscular function was assessed by accelerography. TOF stimulation of ulnar nerve was used. The onset time, recovery time of first twitch (Ti) and recovery time of TOFR 25% were recorded.Results:Date for part three suggests:there was no significant difference in onset time, recovery time of first twitch and recovery time of TOFR 25% between groupⅠand control group. In groupⅡand groupⅢ, recovery time of first twitch (T1) and recovery time of TOFR 25% were significantly shoter than control group and group I respectively.Conclusion:Cisatracurium was kept in room temperature for 4h, which has little effects on the course of neuromuscular blockade. However, the clinical duration of cisatr-acurium was siginificantly shorter when it was kept in room temperature for 12h or when it was diluted two times with 0.9%sodium chloride and then kept in room temperature for 4h. |
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