Abstract:
Objective To investigate the effect of age on median effective dose(ED50)of rocuronium on tracheal intubation following anesthesia of propofol combined with etomidate.
Methods A total of 160 patients with elective operation under general anesthesia were selected as study objects, and were divided into group A(n=51, aged from 18 to 40 years), groups B(n=54, aged from 41 to 65 years) and group C(n=55, aged from 66 to 79 years) according different ages. The sequential method was conducted in three groups, with initial dosages of 0.348 mg/kg in the group A, 0.290 mg/kg in the group B and 0.242 mg/kg in the group C. The heart rate (HR), blood oxygen saturation (SpO2), mean arterial pressure (MAP) at the time points of induced anesthesia (T0), intubation (T1), 1 min after intubation (T2), 3 min after intubation (T3) and extubation (T4) were compared, tracheal intubation condition, induction time, onset time, and awakening time, pain scores and adverse reactions were recorded. Rocuronium ED50 and 95% confidence interval (95%CI) were calculated.
Results There was no difference in tracheal intubation condition of three groups(P > 0.05). There were no differences in heart rate (HR) and SpO2 of three groups at each time point(P > 0.05), while the levels of MAP of the group B and group C were higher than the group A at each time point(P < 0.05). Compared with the group A and the group B, the induction and onset time of the group C was shorter, while the recovery time was longer(P < 0.05). There were no significant differences in induction time, onset time and recovery time between the group A and the group B (P > 0.05). There was no statistical significance in the grading of pain degree after awakening among three groups (P > 0.05). The ED50 of the group C was 0.267 mg/kg (95%CI, 0.223 to 0.320), which was significantly lower than 0.321 mg/kg (95%CI, 0.297 to 0.347) and 0.314 mg/kg (95%CI, 0.283 to 0.348) of the groups A and B(P < 0.05). There was no significant difference in ED50 between the group A and the group B (P > 0.05). There were no significant difference of incidence of preoperative, intraoperative and postoperative adverse reactions of three groups (P > 0.05).
Conclusion Age is an important interfering factor on ED50 of rocuronium on tracheal intubation following anesthesia of propofol combined with etomidate, the values of ED50 for patients aged 18 to 40, 41 to 65 and 66 to 79 years are 0.321 mg/kg, 0.314 mg/kg and 0.267 mg/kg, respectively.