Anest. intenziv. Med. 2010;21(2):78-84

Influence of age on the pharmacodynamic parameters of cisatracurium, rocuronium and vecuronium in males during total intravenous anaesthesia - a prospective studyAnaesthesiology - Original Paper

Adamus Milan

Klinika anesteziologie a resuscitace, Fakultní nemocnice a Lékařská fakulta Univerzity Palackého v Olomouci

Objective:
To compare the pharmacodynamics of cisatracurium, rocuronium and vecuronium following a single dose in young and elderly males during TIVA.

Design:
Clinical, prospective, controlled, randomized study.


Setting:
Department of Anaesthesiology, University Hospital.

Materials and methods:
Following ethics committee approval and patients' informed consent, 240 males of two age groups (20-40, 60-75 years) received cisatracurium, rocuronium or vecuronium (2×ED95). For each patient, neuromuscular monitoring (TOF, electromyography) determined the onset time (maximal T1 depression), clinical duration (25% recovery of T1) and full recovery (TOF-ratio ≥ 0.9). Mann-Whitney or Kruskal-Wallis test were used to compare the differences between young and elderly patients.

Results:
The median onset times (seconds) were 205 vs. 255* for cisatracurium, 95 vs. 133* for rocuronium and 210 vs. 250* for vecuronium in the young and elderly patients, respectively (*p < 0.001). The median clinical duration (minutes) was 44 vs. 43.5 (p = 0.568) for cisatracurium, 36 vs. 58* for rocuronium and 32 vs. 60* for vecuronium in the young and elderly patients, respectively. Finally, the median full recovery times (minutes) were 71 vs. 77 (p = 0.095) for cisatracurium, 60 vs. 103* for rocuronium and 56 vs. 92* for vecuronium, in the young and elderly patients, respectively.

Conclusion:
The onset was slower in the elderly. Both clinical duration and full recovery for rocuronium and vecuronium were longer in the elderly whereas these parameters for cisatracurium were age-independent.

Keywords: pharmacodynamics; cisatracurium; rocuronium; vecuronium; age

Published: April 1, 2010  Show citation