Influence of age on the recovery of neuromuscular function after continuous infusion of rocuronium bromide / 中华老年医学杂志

ABSTRACT

Objective To investigate the influence of age on recovery from neuromuscular blocking after continuous infusion of rocuronium bromide.Methods A total of 60 patients receiving general anesthesia were assigned to one of four groups according to age≤44 years old group (n=12),45-59 years old group (n=18),60-74 years old group (n=15),and ≥75 years old group (n=15).Total intravenous anesthesia was used for both induction and maintenance of anesthesia.The train-of four (TOF) was applied for measuring acceleromyography.The induction of anesthesia was conducted with 0.6 mg/kg rocuronium bromide,and 0.3-0.6 mg · kg-1 · h-1 rocuronium bromide was continuously intravenouoly infused until 30 minutes before the end of operation by a micro-pump to maintain T1 between 10-20％.Recovery index (RI),recovery time of TOFr 70％ and TOFr 90％,and the average infusion rate of the four groups were collected.Results The RI,TOFr 70％ recovery time,and TOFr 90％ recovery time in the ≥75 years old group [28.9±10.0,(59.8±12.1) min,(38.6±10.6) min] were higher than those in the other three groups [≤44 years old group21.4±7.0,(40.2±11.0) min,(27.610.0) min;the 45-59 years old group22.8±7.0,(42.4±11.8) min,(28.7±9.2) min;the 60-74 years old group21.1±7.9,(41.0±9.8) min,(26.1±6.7) min] (all P ＜0.05 or 0.01).The average infusion rate for the ≤44 years old group (0.41±0.1) mg·kg-1·h-1was higher than that for the 60-74 years old group (0.33±0.06) mg·kg-1·h-1(P＜0.01);The rate for the ≥75 years old group (0.32±0.06) mg·kg-1 ·h-1 was lower than that for the ≤44 years old group and that for the 45-59 years old group (0.38±0.08) mg·kg-1 ·h-1 (P＜0.05 or ＜0.01)Conclusions After continuous infusion of rocuronium bromide,patients aged 75 or over need more time to recover their myodynamia than younger people do.The myodynamia recovery time is longer after continuous bromide infusion than after a single dose injection of rocuronium bromide,but it still follows a similar pattern.For the same level of muscle relaxation in the elderly,a lower dose of rocuronium bromide is required.