The neuromuscular effects of 0.6 mg kg−1 rocuronium in elderly and young adults with or without renal failure*

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The elderly represent a wide and increasing patient population and significant numbers of elderly patients have chronic renal disease. This study aimed to investigate the neuromuscular effects of 0.6 mg kg(-1) rocuronium under propofol anaesthesia in young adults and elderly patients with or without renal failure. The neuromuscular effects of rocuronium 0.6 mg kg(-1) under propofol anaesthesia were investigated in 40 patients with renal failure undergoing arteriovenous shunt surgery, of whom 20 were young adults (18-50 yr) and 20 were elderly (>65 yr) and in 40 patients with normal renal function undergoing peripheral venous surgery, of whom 20 were young adults and 20 were elderly. Neuromuscular transmission was monitored using acceleromyography. The times to recovery of the twitch (T1) to 25%, 50%, 75% and 90% and of the train-of-four ratio to 70%, and the recovery index were recorded. The times to recovery of the first twitch to 25%, 50%, 75% and 90% and train-of-four to 70% and recovery index were found to be prolonged in both young and elderly patients with renal failure compared to those with normal renal function (e.g. T1 25%: 58.4 +/- 20.2 and 80.1 +/- 23.7 min vs. 32.8 +/- 5.6 and 46.3 +/- 9.0 min, respectively) (P < 0.05). These parameters were also prolonged in the elderly when compared with young adults in both the renal failure and the non-renal failure groups. The neuromuscular effects of 0.6 mg kg(-1) rocuronium under propofol anaesthesia were markedly prolonged in young and elderly renal failure patients compared to patients with normal renal function, and also in elderly patients with normal renal function compared with young adults.