Neuromuscular blocking effect of rocuronium in patients with portal hypertension / 中华麻醉学杂志

ABSTRACT

Objective Since rocuronium (R) is excreted unchanged in the urine and bile, thus the duration of action may be increased in patients with liver dysfunction. The purpose of this study was to evaluate the neuromuscular blocking effect of R in patients with portal hypertension. Methods Seventy ASAⅠ-Ⅱ patients (36 males, 34 females) aged 30-60 yrs were divided into 2 groups portal hypertension group (n=36) (PH) and control group (C) (n = 34). The liver function of the patients in PH group was classified as Child-Turcottee grade Ⅱ while those in C group had no liver dysfunction. The patients were premedicated with intramuscular phenobarbital 0.1 g and atropine 0.5 mg. Anesthesia was induced with midazolam 0.02 mg?kg-1 , propofol 1.0 mg?kg-1 , fentanyl 5 ?g?kg-1 and R 0.6 mg?kg-1 and maintained with isoflurane and intermittent i.v. boluses of fentanyl. R was continuously infused. The patients were mechanically ventilated after tracheal intubation. PETCO2 was maintained at 35-45 mm Hg . The N-M function was monitored by accelerography using TOF stimulation. (1) The onset time (from the end of R injection to maximal paralysis (T1=0). (2) Maximum depression time (the duration of completely no response to TOF stimulation. (3) Maintenance time (T1 returned to 10% ) . (4) recovery time (T1 returned to 25% after R infusion was stopped) and (5) recovery index (T1 returned from 25%-75%) were recorded. The amount of R infused every 30 min was also recorded. Results The two groups were comparable with respect to sex and age. The onset time and maximum depression time were significantly longer in PH group than in group C ( P