Shortened time to neuromuscular recovery with lower doses of rocuronium in elderly patients.


Journal

Danish medical journal
ISSN: 2245-1919
Titre abrégé: Dan Med J
Pays: Denmark
ID NLM: 101576205

Informations de publication

Date de publication:
13 May 2024
Historique:
medline: 7 6 2024
pubmed: 7 6 2024
entrez: 7 6 2024
Statut: epublish

Résumé

The effect of neuromuscular blocking agents may be reversed by administration of neostigmine, when two twitches are present using train-of-four (TOF) stimulation. However, in elderly patients, limited data are available about when to administer neostigmine. We hypothesised that time to two twitches after TOF (TOF-2) was shorter after rocuronium 0.6 mg/kg than after rocuronium 0.9 mg/kg. Also, we hypothesised that time to TOF-2 would be shorter after rocuronium 0.3 mg/kg than after rocuronium 0.6 mg/kg. This was a secondary analysis of 50 elderly patients > 80 years; 16 patients received rocuronium 0.6 mg/kg, another 16 patients received rocuronium 0.9 mg/kg; and, finally, 18 patients received rocuronium 0.3 mg/kg. Patients received total intravenous anaesthesia, and neuromuscular block was monitored with acceleromyography. Time to TOF-2 was shorter after rocuronium 0.6 mg/kg than after rocuronium 0.9 mg/kg: 37 min. versus 59 min. (difference: 22 min. (95% confidence intervals (CI): 10 to 33 min.), p = 0.0007). Time to TOF-2 after rocuronium 0.3 mg/kg was shorter than after rocuronium 0.6 mg/kg: 19 min. versus 37 min. (difference: 18 min. (95% CI: 11 to 25 min.), p = 0.00006). However, only 33% of the patients receiving 0.3 mg/kg obtained full effect i.e. TOF-0. Time to TOF-2 was shorter after rocuronium 0.6 mg/kg than after 0.9 mg/kg and shorter after rocuronium 0.3 mg/kg than after 0.6 mg/kg. This work was supported by departmental sources. This study was a secondary analysis of two clinical trials. gov (NCT04512313), (NCT03857750).

Identifiants

pubmed: 38847412
pii: A09230578
doi: 10.61409/A09230578
pii:
doi:

Substances chimiques

Rocuronium WRE554RFEZ
Neuromuscular Nondepolarizing Agents 0
Neostigmine 3982TWQ96G
Androstanols 0

Banques de données

ClinicalTrials.gov
['NCT04512313', 'NCT03857750']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Published under Open Access CC-BY-NC-BD 4.0. https://creativecommons.org/licenses/by-nc-nd/4.0/.

Auteurs

Sarah Sofie Wadland (SS)

Department of Anaesthesiology, Centre of Head and Orthopaedics, Section 6011, Copenhagen University Hospital - Rigshospitalet, Denmark.

Lars Simon Rasmussen (LS)

Department of Anaesthesiology, Centre of Head and Orthopaedics, Section 6011, Copenhagen University Hospital - Rigshospitalet, Denmark.

Matias Vested (M)

Department of Anaesthesiology, Centre of Head and Orthopaedics, Section 6011, Copenhagen University Hospital - Rigshospitalet, Denmark.

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Classifications MeSH