Anaesthesia, critical care & pain medicine · 2022
Influence of the amount of skeletal muscle mass on rocuronium-induced neuromuscular block.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Doo A Ram, Lee Jun Ho, Lee Youngkwan, Ko Seonghoon
Аннотация
OBJECTIVE: To evaluate the effects of skeletal muscle mass on the rocuronium-induced neuromuscular block.
DESIGN: A prospective, double-blinded, observational study.
SETTING: A tertiary care university hospital.
POPULATION: One hundred one patients aged 18-65 years who were scheduled to undergo major surgery lasting more than 1 h under general anaesthesia.
METHODS: All participants underwent body composition analysis before anaesthesia and were allocated into two groups; the muscular and non-muscular group, according to skeletal muscle mass. During anaesthesia induction, rocuronium 1.0 mg kg-1 of total body weight was injected followed by neuromuscular monitoring using train-of-four stimulation every 15 s.
MAIN OUTCOME MEASURES: The onset time of rocuronium included the elapsed time from the rocuronium injection until 95% depression of first twitch (T1) and the time to no response to TOF stimulation. The duration was evaluated as the elapsed time from the rocuronium injection to 25% recovery of the final T1 (TDUR25), and the time to the reappearance of T1 (TTOF1) and T4 (TTOF4). These pharmacologic data were compared between two groups.
RESULTS: There was no significant difference in the onset time of rocuronium between the two groups. However, TDUR25 (min) was significantly shorter in the muscular group than in the non-muscular group (p = 0.035 and p = 0.014 in males and females, respectively). TTOF1 and TTOF4 were also shorter in the muscular group than in the non-muscular group.
CONCLUSIONS: Total body weight-based dosing of rocuronium might prolong the neuromuscular relaxation effect in patients with a small amount of skeletal muscle.
DESIGN: A prospective, double-blinded, observational study.
SETTING: A tertiary care university hospital.
POPULATION: One hundred one patients aged 18-65 years who were scheduled to undergo major surgery lasting more than 1 h under general anaesthesia.
METHODS: All participants underwent body composition analysis before anaesthesia and were allocated into two groups; the muscular and non-muscular group, according to skeletal muscle mass. During anaesthesia induction, rocuronium 1.0 mg kg-1 of total body weight was injected followed by neuromuscular monitoring using train-of-four stimulation every 15 s.
MAIN OUTCOME MEASURES: The onset time of rocuronium included the elapsed time from the rocuronium injection until 95% depression of first twitch (T1) and the time to no response to TOF stimulation. The duration was evaluated as the elapsed time from the rocuronium injection to 25% recovery of the final T1 (TDUR25), and the time to the reappearance of T1 (TTOF1) and T4 (TTOF4). These pharmacologic data were compared between two groups.
RESULTS: There was no significant difference in the onset time of rocuronium between the two groups. However, TDUR25 (min) was significantly shorter in the muscular group than in the non-muscular group (p = 0.035 and p = 0.014 in males and females, respectively). TTOF1 and TTOF4 were also shorter in the muscular group than in the non-muscular group.
CONCLUSIONS: Total body weight-based dosing of rocuronium might prolong the neuromuscular relaxation effect in patients with a small amount of skeletal muscle.