%0 Journal Article
%T Shortened time to neuromuscular recovery with lower doses of rocuronium in elderly patients.
%A Wadland SS
%A Rasmussen LS
%A Vested M
%J Dan Med J
%V 71
%N 6
%D 2024 May 13
%M 38847412
%F 1.865
%R 10.61409/A09230578
%X <B>BACKGROUND: </B>The effect of neuromuscular blocking agents may be reversed by administration of neostigmine, when two twitches are present using train-of-four (TOF) stimulation. However, in elderly patients, limited data are available about when to administer neostigmine. We hypothesised that time to two twitches after TOF (TOF-2) was shorter after rocuronium 0.6 mg/kg than after rocuronium 0.9 mg/kg. Also, we hypothesised that time to TOF-2 would be shorter after rocuronium 0.3 mg/kg than after rocuronium 0.6 mg/kg.<BR><B>METHODS: </B>This was a secondary analysis of 50 elderly patients > 80 years; 16 patients received rocuronium 0.6 mg/kg, another 16 patients received rocuronium 0.9 mg/kg; and, finally, 18 patients received rocuronium 0.3 mg/kg. Patients received total intravenous anaesthesia, and neuromuscular block was monitored with acceleromyography.<BR><B>RESULTS: </B>Time to TOF-2 was shorter after rocuronium 0.6 mg/kg than after rocuronium 0.9 mg/kg: 37 min. versus 59 min. (difference: 22 min. (95% confidence intervals (CI): 10 to 33 min.), p = 0.0007). Time to TOF-2 after rocuronium 0.3 mg/kg was shorter than after rocuronium 0.6 mg/kg: 19 min. versus 37 min. (difference: 18 min. (95% CI: 11 to 25 min.), p = 0.00006). However, only 33% of the patients receiving 0.3 mg/kg obtained full effect i.e. TOF-0.<BR><B>CONCLUSIONS: </B>Time to TOF-2 was shorter after rocuronium 0.6 mg/kg than after 0.9 mg/kg and shorter after rocuronium 0.3 mg/kg than after 0.6 mg/kg.<BR><B>BACKGROUND: </B>This work was supported by departmental sources.<BR><B>BACKGROUND: </B>This study was a secondary analysis of two clinical trials.<BR><B>RESULTS: </B>gov (NCT04512313), (NCT03857750).