Effects Of Different Progesterone Levels On Neuromuscular Blockade Of Rocuronium In Patients Undergoing Laparoscopic Surgery

ObjectiveThe female sex hormones change in a cyclical manner in different menstrual cycle(such as:follicular phase,luteal phase).To investigate the effects of different progesterone levels on neuromuscular blockade of rocuronium in patients undergoing laparoscopic surgery.To provide a reasonable medication for the different menstrual cycle of women in the surgical process of muscle relaxants.Methods60 female patients,ASA ?-?,ages 18?45 year,BMI 18?24kg/m2,undergoing laparoscopic surgery were included.All patients were taken venous blood sample 4ml before the surgery.The 60 cases were divided into two groups according to different progesterone level:high level group(H group)and low level group(L group),each group had 30 patients.ECG,HR,MAP,SpO2,PEtCO2,BIS and invasive arterial blood pressure were monitored.Used TOF-Watch SX acceleration to monitor muscle relaxation by train-of-four Stimulation(TOF).Anesthsia was induded with propofol-remifentail given by target controlled infusion(TCI).The target effect site concentration of propofol was 3ug/ml and that of remifentanil was 4ng/ml.The muscle relaxation monitor was activated When the BIS showed 80,then patients were injected rocuronium 0.6mg/kg and intubated after loss of consciousness.The target effect site concentration of propofol and remifentanil were 2?4ug/ml and 3?6ng/ml during all the surgery process.The BIS was maintained at 40 to 60.Before the start of the surgery according to the patient's vital signs to adjust the drug dosage of propofol and remifentanil.The second and one week after the operation,patients were interviewed for any recall or complications.During the surgery process,we recorded the indexs of rocuronium of all patients,included the onset time of rocuronium,the clinical working time,muscle twitch maximal inhibition,the time of T1 returned to 25%and the time of TOFr returned to 25%.Results(1)No patients showd any cardiovascular and respiratory complications.No patiens had drug allergy reaction.(2)There was no significant difference in the age and BMI between the H group and the L group(P>0.05).(3)Muscle twitch maximal inhibition between the H group and the L group were all 100%,the differences was no significant(P>0.05).(4)Compared with L group,the onset time of rocuronium of the H group was shorter,the differences were statistically significant(P>0.05).Compared with L group,the clinical working time of rocuronium of the H group was longer,the differences were statistically significant(P>0.05).Compared with L group,the time of T1 returned to 25%of the H group was longer,the differences were statistically significant(P>0.05).Compared with L group,the time of TOFr returned to 25%of the H group was longer,the differences were statistically significant(P>0.05).Conclusion(1)Progesterone enhanced the effect of muscle relaxation of rocuronium,shorten the onset time of rocuronium.(2)Compared with follicular phase,in Luteal phase the dosage of rocuronium should be reduced,the additional interval should be extended.(3)Changes in progesterone levels in female patients did not affect the degree of muscle relaxation in rocuronium.