2002•Zhonghua mazuixue zazhiRequires access
Effect of malnutrition on rocuronium induced neuromuscular blockade
Yucong Yang
Open publisher page 0 citations
Abstract
Objective It has been reported that nutritional status of the patients affects neuromuscular (N-M) blockade induced by succinylcholine, tubocurarine, atracurium and vecuronium. The purpose of this study was to investigate the effect of malnutrition on rocuronium induced N-M block. Methods Forty ASA Ⅰ -Ⅱ patients undergoing surgery under general anesthesia were divided into four groups of 12 patients each, based on body mass index (BMI): I normal group BMI = 18.5-25kg· m-2 ;Ⅱ mild malnutrition group BMI= 17-18.5 kg·m-2 ;Ⅲ moderate malnutrition groups BMI = 16-17 kg·m-2 and Ⅳ severe malnutrition group BMK16 kg·m-2 .N-M blockade was monitored using TOF technique. Anesthesia was induced with fentanyl 4-5μg ·kg-1 and etomidate 0. 3mg·kg-1 . When the patient was asleep rocuronium 0.6 mg·kg-1 was given iv in 5 s following establishment of control twitch parameters. When the depression of T1 was 90% the patient was intubated and mechanically ventilated. PETCO2 was maintained at 4.0-4.7kPa. Anesthesia was maintained with 0.5%-0.7% isoflurane +60% N2O. During operation when T1 returned to 25% of control rocuronium 0.15mg·kg-1 was supplemented. The onset time, degree of N-M block and duration of action of initial and supplemental dose were recorded.Results With initial dose the onset time was delayed in group Ⅲ [(184±58)s] and group Ⅳ [(252±62) s] as compared with that in group Ⅰ [(122±33 )s] (P0.05); the maximal depression of T1 was less in groupⅣ(95.17%±3.88%) than that in group Ⅰ(98.83% ±0.39% ) (P0.05); the duration of action was shorter in group Ⅲ[(26± 6) min] and Ⅳ [(25 ± 7) min] than that in group Ⅰ[ (37 ± 9) min] (P0.05) . With supplemental dose the duration of action was shorter in group Ⅲ [ (19 ±4) min] and Ⅳ [(17±4) min] than that in groupⅠ [(25 ± 6 min) ](P 0.05) . There was no difference in recovery from N-M block between the groups (P0.05) .Conclusions The neuromuscular blockade induced by rocuronium is reduced in patients with moderate and severe malnutrition.