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The neuromuscular effects of 0.6 mg kg−1 rocuronium in elderly and young adults with or without renal failure*

Published online by Cambridge University Press:  01 November 2008

S. Kocabas ,
D. Yedicocuklu  and
F. Z. Askar
S. Kocabas*
Affiliation:
Ege University, Faculty of Medicine, Department of Anaesthesiology and Reanimation, Izmir, Turkey
D. Yedicocuklu
Affiliation:
Ege University, Faculty of Medicine, Department of Anaesthesiology and Reanimation, Izmir, Turkey
F. Z. Askar
Affiliation:
Ege University, Faculty of Medicine, Department of Anaesthesiology and Reanimation, Izmir, Turkey
*
Correspondence to: Seden Kocabas, Cemal Gursel Caddesi, 418/9, Gunaydin Apt, 35530 Karsiyaka-Izmir, Turkey. E-mail: nskocabas@yahoo.com.tr; Tel: +90 232 3695394; Fax: +90 232 3390002
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Summary

Background and objectives

The elderly represent a wide and increasing patient population and significant numbers of elderly patients have chronic renal disease. This study aimed to investigate the neuromuscular effects of 0.6 mg kg−1 rocuronium under propofol anaesthesia in young adults and elderly patients with or without renal failure.

Methods

The neuromuscular effects of rocuronium 0.6 mg kg−1 under propofol anaesthesia were investigated in 40 patients with renal failure undergoing arteriovenous shunt surgery, of whom 20 were young adults (18–50 yr) and 20 were elderly (>65 yr) and in 40 patients with normal renal function undergoing peripheral venous surgery, of whom 20 were young adults and 20 were elderly. Neuromuscular transmission was monitored using acceleromyography. The times to recovery of the twitch (T1) to 25%, 50%, 75% and 90% and of the train-of-four ratio to 70%, and the recovery index were recorded.

Results

The times to recovery of the first twitch to 25%, 50%, 75% and 90% and train-of-four to 70% and recovery index were found to be prolonged in both young and elderly patients with renal failure compared to those with normal renal function (e.g. T1 25%: 58.4 ± 20.2 and 80.1 ± 23.7 min vs. 32.8 ± 5.6 and 46.3 ± 9.0 min, respectively) (P < 0.05). These parameters were also prolonged in the elderly when compared with young adults in both the renal failure and the non-renal failure groups.

Conclusions

The neuromuscular effects of 0.6 mg kg−1 rocuronium under propofol anaesthesia were markedly prolonged in young and elderly renal failure patients compared to patients with normal renal function, and also in elderly patients with normal renal function compared with young adults.

Keywords

NEUROMUSCULAR NON-DEPOLARIZER AGENTSPHARMACODYNAMICSKIDNEY FAILURE CHRONICAGED
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue 11 , November 2008 , pp. 940 - 946
Copyright
Copyright © European Society of Anaesthesiology 2008

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Footnotes

*

This study was presented at the Euroanaesthesia Congress, Munich, 9–12 June 2007.

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