Abstract
BackgroundAn increasing number of patients older than 80 years are undergoing anesthesia, but little information is available regarding pharmacodynamic effects of myorelaxants in this population. This study aims to compare the time course of rocuronium neuromuscular block in patients ≥ 80 years with those of younger adults.MethodsUnder total intravenous anesthesia with propofol and sufentanil, time course of a bolus of rocuronium 0.6 mg/kg neuromuscular block was assessed with acceleromyography in patients ≥ 80 and in patients 20–50 years old. Onset time, clinical duration, duration until 90% and 100% recovery of baseline were determined.ResultsData from 32 patients were analyzed, 16 were ≥ 80 years and 16 were 20–50 years old. Demographic data are shown in Table 1. In the group ≥ 80, onset time was 190 s ± 46 s compared to 123 s ± 40 s in the group 20–50, P < 0.001 and the clinical duration was 52 [48–69.5] min and 36 [34–41] min, respectively, P < 0.001. Duration to 90% recovery of baseline was 77.5 [71–88.5] min and duration to 100% recovery of baseline was 91.2 [82.2–98] min in patients ≥ 80 years and the corresponding values in the patients 20–50 years old were 53.5 [49–55.5] min and 59.5 [56.5–70.25] min, respectively, P < 0.001.ConclusionCompared to younger adults rocuronium shifted in patients ≥ 80 years from a rapid onset, intermediate acting compound to a slower onset, long-acting compound.Trial registrationClinicalTrials.gov identifier: NCT03551652 (29/05/2018).
Highlights
Neuromuscular blocking agents (NMBA) are used to facilitate tracheal intubation and improve surgical conditions [1,2,3]
The risk of residual paralysis and respiratory complications is markedly increased among elderly patients [7, 8]
All patients gave written informed consent, and all clinical data were obtained in our department. 35 patients scheduled for a surgical procedure under general anesthesia were included between May 2020 and March 2021
Summary
Neuromuscular blocking agents (NMBA) are used to facilitate tracheal intubation and improve surgical conditions [1,2,3]. Residual neuromuscular blockade is commonly seen postoperatively and patients with residual paralysis have an increased risk of postoperative respiratory complications such as hypoxemia and upper airway obstruction [4,5,6]. The risk of residual paralysis and respiratory complications is markedly increased among elderly patients [7, 8]. Schmartz et al BMC Anesthesiol (2021) 21:225 The aim of this prospective, controlled observational study was to compare the time course of neuromuscular blockade after rocuronium 0.6 mg/kg in patients ≥ 80 years old with patients between 20-50 years. We hypothesized that patients ≥ 80 years old have slower onset and increased duration and recovery of neuromuscular blockade. This study aims to compare the time course of rocuronium neuromuscular block in patients ≥ 80 years with those of younger adults
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