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Comparison of two rocuronium bromide doses in adult and elderly patients who underwent laparoscopic surgery
Abstract
Background The aim of our study was to evaluate the effects of two different doses of rocuronium bromide (0.5 mg/kg and 0.9 mg/kg) on the length of neuromuscular block, on the haemodynamic stability and on the side effects in patients of different ages. Methods We recruited 80 patients who underwent laparoscopic surgery (cholecystectomy, appendicectomy, varicocelectomy) belonging to ASA I–II classes and divided them into four groups:
• 20 adults (A0.5) who received rocuronium bromide 0.5 mg/kg
• 20 elderly patients (E0.5) who received rocuronium bromide 0.5 mg/kg
• 20 adults (A0.9) who received rocuronium bromide 0.9 mg/kg
• 20 elderly patients (E0.9) who received rocuronium bromide 0.9 mg/kg
Intubation conditions, continuous monitoring of HR, NIBP, SpO2, EtCO2 were recorded. Onset time, REC 25%, TOF-ratio 0.70 were analysed by TOF-WATCH.
Nerve-evoked muscle tension and neuromuscular paralysis extension were expressed by strength of contraction of adductor pollicis, in response to a direct stimulation of the ulnar nerve (TOF). Results The results showed that in elderly patients the effect of rocuronium bromide, at two different doses, was similar. Significant differences regarding the onset time was found among the groups showing that with the same dose of rocuronium bromide, the onset time was prolonged in elderly patients compared to adult patients. Moreover, increasing the dose, the onset time was reduced in both groups (p < 0.05). Forty per cent of adult group A0.5 showed excellent intubation conditions versus 60% of A0.9 (p < 0.05); elderly patients did not show any significant difference in the intubation procedure after different doses of rocuronium bromide.
Conclusions
The results from the four groups showed that in elderly patients 0.5 mg/kg of rocuronium bromide resulted in a good recovery, while 0.9 mg/kg increased the recovery time. Moreover, in adults the high dose was more effective because it reduced the number of injections and post-operative recovery time.
• 20 adults (A0.5) who received rocuronium bromide 0.5 mg/kg
• 20 elderly patients (E0.5) who received rocuronium bromide 0.5 mg/kg
• 20 adults (A0.9) who received rocuronium bromide 0.9 mg/kg
• 20 elderly patients (E0.9) who received rocuronium bromide 0.9 mg/kg
Intubation conditions, continuous monitoring of HR, NIBP, SpO2, EtCO2 were recorded. Onset time, REC 25%, TOF-ratio 0.70 were analysed by TOF-WATCH.
Nerve-evoked muscle tension and neuromuscular paralysis extension were expressed by strength of contraction of adductor pollicis, in response to a direct stimulation of the ulnar nerve (TOF). Results The results showed that in elderly patients the effect of rocuronium bromide, at two different doses, was similar. Significant differences regarding the onset time was found among the groups showing that with the same dose of rocuronium bromide, the onset time was prolonged in elderly patients compared to adult patients. Moreover, increasing the dose, the onset time was reduced in both groups (p < 0.05). Forty per cent of adult group A0.5 showed excellent intubation conditions versus 60% of A0.9 (p < 0.05); elderly patients did not show any significant difference in the intubation procedure after different doses of rocuronium bromide.
Conclusions
The results from the four groups showed that in elderly patients 0.5 mg/kg of rocuronium bromide resulted in a good recovery, while 0.9 mg/kg increased the recovery time. Moreover, in adults the high dose was more effective because it reduced the number of injections and post-operative recovery time.
