Effect of age on median effective dose of rocuronium on tracheal intubation following anesthesia of propofol combined with etomidate

LIU Xingchu; WU Jing

doi:10.7619/jcmp.20210007

Journal of Clinical Medicine in Practice > 2021 > 25(17): 31-36. > DOI: 10.7619/jcmp.20210007

LIU Xingchu, WU Jing. Effect of age on median effective dose of rocuronium on tracheal intubation following anesthesia of propofol combined with etomidate[J]. Journal of Clinical Medicine in Practice, 2021, 25(17): 31-36. DOI: 10.7619/jcmp.20210007

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Effect of age on median effective dose of rocuronium on tracheal intubation following anesthesia of propofol combined with etomidate

LIU Xingchu¹,
WU Jing^2, ,

1.
Anesthesiology Department, Jianli City People′s Hospital, Jianli, Hubei, 433300
2.
the Affiliated Hospital of Northwest University, Xi′an Third Hospital, Xi′an, Shaanxi, 433300

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Received Date: January 01, 2021
Available Online: October 12, 2021
Published Date: September 14, 2021

Graphical Abstract

Abstract

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.
- propofol,
- etomidate,
- rocuronium,
- median effective dose,
- tracheal intubation,
- anaesthesia

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References (23)

References

[1]	WINDPASSINGER M, PLATTNER O, GEMEINER J, et al. Opioid use after propofol or sevoflurane anesthesia: a randomized trial[J]. Can J Anesth Can D'anesthésie, 2016, 63(11): 1258-1265. doi: 10.1007/s12630-016-0728-5
[2]	王建珍, 李国燕, 刘冬梅. 预注地佐辛对抑制依托咪酯乳剂诱发肌阵挛和插管应激反应的影响[J]. 广东医学, 2018, 39(1): 31-33, 36. https://www.cnki.com.cn/Article/CJFDTOTAL-GAYX201801010.htm
[3]	韩明明, 刘自由, 杨成伟, 等. 性别因素对癫痫患者罗库溴铵肌松效应的影响[J]. 中华麻醉学杂志, 2020, 40 (1): 68-70.
[4]	于凯, 王国林, 闫东来. 不同浓度七氟醚联合丙泊酚麻醉对罗库溴铵药效学的影响[J]. 天津医药, 2016, 44(3): 341-344. https://www.cnki.com.cn/Article/CJFDTOTAL-TJYZ201603022.htm
[5]	ADAMUS M, HRABALEK L, WANEK T, et al. Influence of age and gender on the pharmacodynamic parameters of rocuronium during total intravenous anesthesia[J]. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 2011, 155(4): 347-353. doi: 10.5507/bp.2011.050
[6]	王斌, 周俊飞, 张欢. 年龄对持续输注罗库溴铵后肌松驰恢复的影响[J]. 中华老年医学杂志, 2018, 37(4): 441-444.
[7]	MUPPARAPU M, SINGER S R. Editorial: The American Society of Anesthesiologists (ASA) physical status classification system and its utilization for dental patient evaluation[J]. Quintessence Int, 2018, 49(4): 255-256. http://www.ncbi.nlm.nih.gov/pubmed/29532816
[8]	李露, 王晓林, 周海滨, 等. 右美托咪定局部用药对罗哌卡因臂丛神经阻滞半数有效浓度的影响[J]. 中华麻醉学杂志, 2013(3): 328-330. https://www.cnki.com.cn/Article/CJFDTOTAL-GAYX201805029.htm
[9]	MITRA S, PUROHIT S, BHATIA S, et al. A comparative study of effect of sevoflurane on intubating conditions with rocuronium in neurosurgical patients[J]. Indian J Anaesth, 2015, 59(12): 774-778. doi: 10.4103/0019-5049.171557
[10]	MENON J, CAPPELLERI J C, MARDEKIAN J, et al. Psychometric properties of the sf-12, penn shoulder score, and visual analogue scale-pain for rotator cuff retears[J]. Applied Medical Research, 2015, 1(3): 1. http://www.ejmanager.com/mnstemps/126/126-1432609840.pdf
[11]	黄珂, 王小华, 常慧, 等. 序贯法研究顺式阿曲库铵在短小全麻手术喉罩置入满意时的半数有效剂量[J]. 北京医学, 2019, 41(8): 712-714, 719. https://www.cnki.com.cn/Article/CJFDTOTAL-BJYX201908027.htm
[12]	DHANARISI J, SHIHANA F, HARJU K, et al. A pilot clinical study of the neuromuscular blocker rocuronium to reduce the duration of ventilation after organophosphorus insecticide poisoning[J]. Clin Toxicol: Phila, 2020, 58(4): 254-261. doi: 10.1080/15563650.2019.1643467
[13]	钟瑛, 黎必万, 梁军. 预注小剂量阿曲库铵对罗库溴铵缩肢反应的影响[J]. 海南医学, 2019, 30(13): 1687-1690. https://www.cnki.com.cn/Article/CJFDTOTAL-HAIN201913014.htm
[14]	GHOLIPOUR BARADARI A, FIROUZIAN A, ZAMANI KIASARI A, et al. Effect of etomidate versus combination of propofol-ketamine and thiopental-ketamine on hemodynamic response to laryngoscopy and intubation: a randomized double blind clinical trial[J]. Anesth Pain Med, 2016, 6(1): e30071. http://europepmc.org/articles/PMC4834424/
[15]	FRIESEN J H. Propofol induction: normalizing the dose in morbidly obese patients[J]. Can J Anaesth, 2017, 64(5): 456-460. doi: 10.1007/s12630-017-0854-8
[16]	周维纲, 杨建治, 陶维初, 等. 丙泊酚依托咪酯混合剂麻醉对老年患者血流动力学及血清皮质醇的影响[J]. 解放军预防医学杂志, 2018, 36(12): 1535-1538. https://www.cnki.com.cn/Article/CJFDTOTAL-JYYX201812013.htm
[17]	LAPPI J, LUORANEN J. Testing the differences of LT50, LD50, or ED50[J]. Canadian J Forest Res, 2018, 48(6): 729-734. doi: 10.1139/cjfr-2017-0377
[18]	康定鑫, 饶裕泉, 姬斌, 等. 七氟烷和地氟烷对患儿术中罗库溴铵药效动力学的影响[J]. 中华医学杂志, 2017, 97(6): 429-433.
[19]	MASUI K, ISHIGAKI S, TOMITA A, et al. Rocuronium pharmacodynamic models for published five pharmacokinetic models: age and sex are covariates in pharmacodynamic models[J]. J Anesth, 2018, 32(5): 709-716. doi: 10.1007/s00540-018-2543-3
[20]	张新建, 王晖玥, 黄穗葵, 等. 老年人按体质量给药罗库溴铵ED95测定及药效学研究[J]. 实用医学杂志, 2020, 36(7): 959-962. https://www.cnki.com.cn/Article/CJFDTOTAL-SYYZ202007029.htm
[21]	WANG B, YANG J, CHEN J, et al. An etomidate analogue with less adrenocortical suppression, stable hemodynamics, and improved behavioral recovery in rats[J]. Anesth Analg, 2017, 125(2): 442-450. doi: 10.1213/ANE.0000000000002063
[22]	ZHANG L, BAO Y, SHI D. Comparing the pain of propofol via different combinations of fentanyl, sufentanil or remifentanil in gastrointestinal endoscopy[J]. Acta Cir Bras, 2014, 29(10): 675-680. doi: 10.1590/S0102-8650201400160008
[23]	CAI G, HUANG Z, ZOU T, et al. Clinical application of a novel endoscopic mask: a randomized controlled trial in aged patients undergoing painless gastroscopy[J]. Int J Med Sci, 2017, 14(2): 167-172. doi: 10.7150/ijms.16919

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Effect of age on median effective dose of rocuronium on tracheal intubation following anesthesia of propofol combined with etomidate