Clinical Study Of Neuromuscular Blockade By Rocuronium For Elderly Patients

ObjectiveRocuronium bromide is an aminosteroidal neuromuscular blocking agent with rapid onset and intermediate duration.In clinical practice,it is commonly administered in combination with the volatile agents,especially sevoflurane.Its blood gas of distribution is fairly low,induction and analepsia are very rapid,stable of induction process and easily accommodation of deapth of anesthesia.So a randomized study was performed to compare the neuromuscular blockade by rocuronium between elderly patients and young adult patients under sevoflurane anesthesia.MethodsForty ASAâ… orâ…¡patients were included for selective operation of neurosurgical. Participating patients were assigned to one of two groups:Group Y,young adult patients aged 25 to 45 years(n=20);Group O,elderly patients aged over 65 years (n=20).All patients were induced with midazolam 0.1mg/kg,fentanyl 4-5μg/kg, propofol 1.5-2mg/kg and 2%lidocaine 1.5-2 mg/kg intravenously without the aid of neuromuscular blocking agents.A single-dose technique and the single-twitch mode of stimulation(acceleromyography,TOF-Watch^?SX)were used in the potency estimation part of study.Injection rocuronium 0.6mg/kg when T₁ stable at 100%.Tracheal intubation was performed when maximal neuromuscular blocking achieved.The variables recorded were as follow:onset time(time from drug administration to maximum effects),no-response time(disappearance of T₁ to appearance of T₁),times to recovery of T₁ to 25%and 75%of control,recovery index(time from T₁ 25%to 75%).The results were analyzed using the Studemt's t test,P＜0.05 was considered significant.ResultsIn the dose of 0.6 mg/kg of rocuronium,there were no differences in onset time, no-response time and 25%recovery time between the two groups:(162.8±39.3)vs (153.4±30.9)sec;(30.2±8.0)vs(26.2±8.7)min and(55.1±10.0)vs(48.7±12.5) min.However,there were statistically significant differences in recovery time and recovery index,they were longer during elderly patients than young adults patients: (92.8±15.7)vs(77.3±19.6)and(40.4±13.1)vs(29.2±11.1)min,respectively(P＜0.05).ConclusionThere is no difference of the duration between elderly patients and young adult patients under sevoflurane anathesia with rocuroniun of single-dose method.Recovery time in a single dose of 0.6 mg/kg of rocuronium is longer in elderly patients than in young adult patients under sevoflurane anaesthesia.