Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2007, 151(2):301-305 | DOI: 10.5507/bp.2007.051

INFLUENCE OF GENDER ON THE ONSET AND DURATION OF ROCURONIUM-INDUCED NEUROMUSCULAR BLOCK

Milan Adamus, Jirina Koutna, Tomas Gabrhelik, Mariana Hubackova, Eva Janaskova
Department of Anaesthesiology and Intensive Care Medicine, Teaching Hospital and Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic

Aims: To assess the influence of gender on the course of rocuronium-induced neuromuscular block following a single bolus dose of 2 × ED95 (0.6 mg kg-1).

Methods: Following the ethics committee approval and informed consent, 245 patients (121 men, 124 women) scheduled for elective general surgery under TIVA with muscle relaxation were studied. After rocuronium 0.6 mg kg-1, the onset time for maximal depression of T1, clinical duration until 25 % recovery and recovery index (T1 from 25 to 75 %) were determined with TOF-Watch® SX accelerometric monitor. The data for male and female groups were compared with appropriate statistical tests (Student's unpaired t-test, Mann-Whitney Rank Sum Test and Fisher's exact test).

Results: Men were significantly larger (p < 0.001) and heavier (p < 0.05) than women, but the body mass index was comparable (ns). The onset time was shorter in females [92.5 (SD 14.2) vs. 104.7 (12.2) s, p < 0.0001]. Clinical duration was increased in females [43.1 (7.9) vs. 31.3 (5.5) min; p < 0.0001], while the recovery index was identical in both groups [14.7 (5.0) min in females and 14.8 (4.0) min in males; ns].

Conclusions: Women are more sensitive than men to the dose 0.6 mg kg-1 of rocuronium. Under the study conditions described, the onset time was shortened and the clinical duration increased in female patients. This suggests that the routine dose of rocuronium should be reduced in women.

Keywords: Neuromuscular block, Gender, Rocuronium, Clinical duration, Onset time, Recovery index

Received: April 14, 2007; Accepted: September 9, 2007; Published: December 1, 2007  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Adamus, M., Koutna, J., Gabrhelik, T., Hubackova, M., & Janaskova, E. (2007). INFLUENCE OF GENDER ON THE ONSET AND DURATION OF ROCURONIUM-INDUCED NEUROMUSCULAR BLOCK. Biomedical papers, 151(2), 301-305. doi: 10.5507/bp.2007.051
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Pleym H, Spigset O, Kharasch ED, Dale O. Gender diff erences in drug eff ects: implications for anesthesiologists. Acta Anaesthesiol Scand 2003; 47:24159. Go to original source... Go to PubMed...
    2. Herold I. Muscle relaxants in anaesthesiology and intensive care medicine (in Czech). 1st edition. Praha: Maxdorf; 2004.
    3. Mallampati SR, Gatt SP, Gugino LD, Desai SP, Waraksa B, Freiberger D, Liu PL. A clinical sign to predict difficult tracheal intubation: a prospective study. Can Anaesth Soc J 1985; 32:42934. Go to original source... Go to PubMed...
    4. References and formulas used by the Body Surface Area Calculator. Formula for Body Mass Index. Formulas for Body Surface Area [on line, cited 2007 Feb 15]. Available from http://www.halls.md/bodysurface- area/refs.htm.
    5. Servin F, Cazalaa JB, Levron JC. Propofol, Sufentanil, Remifentanil in TCI. Bibliographical study of anesthetic agents used in the Base Primea, Fresenius Vial. Le Grand Chemin, Brezins (France): Fresenius Vial, 2003.
    6. Fuchs-Buder T, Claudius C, Skovgaard LT, Eriksson LI, Mirakhur RK, Viby-Mogensen J. Good clinical research practice in pharmacodynamic studies of neuromuscular blocking agents II: the Stockholm revision. Acta Anaesthesiol Scand 2007; 51:789808. Go to original source... Go to PubMed...
    7. Viby-Mogensen J, Ostergaard D, Donati F, Fisher D, Hunter J, Kampmann JP. Pharmacokinetic studies of neuromuscular blocking agents: Good Clinical Research Practice (GCRP). Acta Anaesthesiol Scand 2000; 44:116990. Go to original source... Go to PubMed...
    8. Adamus M, Belohlavek R, Koutna J, Vujcikova M, Janaskova E. Cisatracurium vs. rocuronium: a prospective, comparative, randomized study in adult patients under total intravenous anaesthesia. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2006; 150(2):3338. Go to original source...
    9. Mencke T, Schreiber JU, Knoll H, Werth M, Grundmann U, Rensing H. Infl uence of gender on the intubation conditions with rocuronium. Anaesthesist 2005; 54:8848. Go to original source... Go to PubMed...
    10. Mencke T, Soltesz S, Grundmann U, Bauer M, Schlaich N, Larsen R, Fuchs-Buder T. Time course of neuromuscular blockade after rocuronium. A comparison between women and men. Anaesthesist 2000; 49:60912. Go to original source... Go to PubMed...
    11. Mencke T, Beerhalter U, Fuchs-Buder T. Spontaneous movements, local reactions and pain on injection of rocuronium. A comparison between female and male patients. Acta Anaesthesiol Scand 2001; 45:10025. Go to original source... Go to PubMed...
    12. Mencke T, Schreiber JU, Knoll H, Stracke C, Kleinschmidt S, Rensing H, Silomon M. Women report more pain on injection of a precurarization dose of rocuronium: a randomized, prospective, placebo-controlled trial. Acta Anaesthesiol Scand 2004; 48:12458. Go to original source... Go to PubMed...
    13. Xue FS, Tong SY, Liao X, Liu JH, An G, Luo LK. Dose-response and time course of eff ect of rocuronium in male and female anesthetized patients. Anesth Analg 1997; 85:66771. Go to original source...
    14. Houghton IT, Aun CS, Oh TE. Vecuronium: an anthropometric comparison. Anaesthesia 1992; 47:7416. Go to original source... Go to PubMed...
    15. Xue FS, An G, Liao X, Zou Q, Luo LK. The pharmacokinetics of vecuronium in male and female patients. Anesth Analg 1998; 86:13227. Go to original source...
    16. Semple P, Hope DA, Clyburn P, Rodbert A. Relative potency of vecuronium in male and female patients in Britain and Australia. Br J Anaesth 1994; 72:1904. Go to original source... Go to PubMed...
    17. Melloni C, Devivo P, Launo C, Mastronardi P, Novelli GP, Romano E. Cisatracurium versus vecuronium: a comparative, double blind, randomized, multicenter study in adult patients under propofol/ fentanyl/N2O anesthesia. Minerva Anestesiol 2006; 72:299308.
    18. Hans P, Welter P, Dewandre PY, Brichant JF, Bonhomme V. Recovery from neuromuscular block after an intubation dose of cisatracurium and rocuronium in lumbar disc surgery. Acta Anaesthesiol Belg 2004; 55:12933. Go to original source...
    19. Baillard C, Gehan G, Reboul-Marty J, Larmignat P, Samama CM, Cupa M. Residual curarization in the recovery room after vecuronium. Br J Anaesth 2000; 84:3945. Go to original source... Go to PubMed...
    20. Cammu G, de Baerdemaeker L, den Blauwen N, de Mey JC, Struys M, Mortier E. Postoperative residual curarization with cisatracurium and rocuronium infusions. Eur J Anaesthesiol 2002; 19:12934. Go to original source...
    21. Beaussier M, Boughaba MA. Residual neuromuscular blockade. Ann Fr Anesth Reanim 2005; 24:126674. Go to original source... Go to PubMed...
    22. Viby-Mogensen J. Postoperative residual curarization and evidencebased anaesthesia. Br J Anaesth 2000; 84:3013. Go to original source... Go to PubMed...
    23. Alkhazrajy W, Khorasanee AD, Russell WJ. Muscle weakness after muscle relaxants: an audit of clinical practice. Anaesth Intensive Care 2004; 32:2569. Go to original source...
    24. Berg H, Roed J, Viby-Mogensen J, Mortensen CR, Engbaek J, Skovgaard LT, Kristel JJ. Residual neuromuscular block is a risk factor for postoperative pulmonary complications. A prospective, randomised, and blinded study of postoperative pulmonary complications after atracurium, vecuronium and pancuronium. Acta Anaesthesiol Scand 1997; 41:1095103. Go to original source... Go to PubMed...

    Return to the content