PDF(Pubmed)
Abstract：
This study aimed to investigate the dose-response relationship of rocuronium administered based on skeletal muscle weight and to assess the feasibility of calculating rocuronium dosage by skeletal muscle weight in short surgeries for patients with obesity. This single-center, randomized controlled clinical trial included 71 patients with obesity aged 28-70 years, with body fat percentages (PBF) >20% in men and > 28% in women, ASA status I-III, scheduled for tracheoscopy. Patients were randomly allocated into two groups: skeletal muscle group (SM group) received rocuronium based on the skeletal muscle content (1.0 mg/kg, n = 31), and the conventional administration group (conventional group) received rocuronium based on total body weight (0.45 mg/kg, n = 30). General anesthesia was administered using the same protocol. Parameters recorded included patients\' general condition, muscle relaxant usage, onset time of muscle relaxants, non-response time, clinical effect time, 75% recovery time, and recovery index. Additionally, occurrences of body movement, choking, and incomplete muscle relaxation during surgery were recorded. Compared to the conventional group, the SM group required significantly less rocuronium dosage, resulting in significantly lower non-response time, clinical effect time, 75% recovery time, and recovery index (p < 0.05), and the onset time is slightly longer. Neither group experienced body movement, choking, or incomplete muscle relaxation (p > 0.05). Utilizing skeletal muscle weight to calculate rocuronium dosage in short surgeries for patients with obesity can reduce dosage, shorten recovery time, and prevent residual muscle relaxation while achieving satisfactory muscle relaxation to meet surgical requirements.
摘要：
本研究旨在探讨基于骨骼肌重量的罗库溴铵剂量-反应关系，并评估在肥胖患者短期手术中通过骨骼肌重量计算罗库溴铵剂量的可行性。这个单一中心，随机对照临床试验纳入71例肥胖患者，年龄28-70岁，男性体脂百分比(PBF)>20%，女性>28%，ASA状态I-III，计划进行气管镜检查。患者随机分为两组：骨骼肌组（SM组）根据骨骼肌含量（1.0mg/kg，n=31),常规给药组（常规组）按总体重（0.45mg/kg，n=30)。使用相同的方案进行全身麻醉。记录的参数包括患者的一般情况，肌肉松弛剂的使用，肌肉松弛剂的起效时间，无响应时间,临床见效时间,75%恢复时间,和恢复指数。此外,身体运动的发生，窒息,记录手术过程中肌肉松弛不完全。与常规组相比,SM组需要显著减少罗库溴铵的剂量，导致无响应时间显着降低，临床见效时间,75%恢复时间,和恢复指数(p<0.05)，起效时间稍长。两组都没有经历过身体运动，窒息,或不完全的肌肉松弛（p>0.05）。利用骨骼肌重量计算肥胖患者短期手术中罗库溴铵的剂量可以减少剂量，缩短恢复时间，并防止残余肌肉松弛，同时实现令人满意的肌肉松弛以满足手术要求。
