Performance evaluation of rocuronium target-controlled infusion system in geriatric patients / 中国微创外科杂志

ABSTRACT

Objective To determine the difference between the measured(Cm) and the target rocuronium plasma concentration(Cp) in geriatric patients given by target-controlled infusion(TCI) during laparoscopic rectectomy or colectomy,and to evaluate the performance of the rocuronium TCI system(Szenohradszkay model).Methods Twenty-four ASA I～II patients aged 65～81 years old received selective laparoscopic rectectomy or colectomy.After induction,all patients received rocuronium by TCI system.The beginning Cp was 1000 ng/ml,then increased to 1300,1600,1900,2200,and 2500 ng/ml,according to the neuromuscular transmission response.The endpoint of Cp was determined when the T1 was maintained at 5%～10%.Radial arterial blood samples were taken before anesthesia and before the adjustment of Cp each time,to determine the plasma concentration of rocuronium by using HPLC/MS.We used parameters of bias,precision,and wobble to evaluate the performance of the TCI system. Results The endpoint Cp(when the T1 was maintained at 5%～10%) was 1600 ng/ml in 2 patients,1900 ng/ml in 5 patients,2200 ng/ml in 9 patients,and 2500 ng/ml in 8 patients.The bias,precision,and wolbble of the rocuronium TCI system were 4.69%,14.93%,and 17.24%,respectively. Conclusions The rocuronium TCI system with Szenohradszkay pharmacokinetic model is clinically acceptable for Chinese geriatric patients.