背景:深层神经肌肉阻滞(NMB)在各种外科手术中都有好处,然而,精确的定量神经肌肉监测对于其正确的维护和恢复至关重要。神经肌肉阻断剂的剂量取决于实际体重(ABW),但这因人而异。因此,这项研究假设,深度NMB的罗库溴铵需求量与生物电阻抗分析测得的肌肉质量比之间存在相关性。
方法:本研究纳入90例接受腹腔镜手术的成年女性患者。使用身体组成分析仪评估肌肉和脂肪质量。深度封锁,定义为破伤风后计数为1-2,通过连续输注罗库溴铵来维持。主要结果涉及确定深度阻滞所需的罗库溴铵剂量与肌肉质量比之间的相关性。相反,次要结果包括评估罗库溴铵剂量之间的关系,脂肪质量比,和ABW。此外,我们调查了它们与罗库溴铵起效时间和深度阻断持续时间的关系。
结果:肌肉质量比与保持深度阻滞所需的罗库溴铵剂量之间没有关系(r=0.059[95%CI=0.153-0.267],p=0.586)。脂肪质量比和ABW与罗库溴铵剂量无相关性,而罗库溴铵起效时间与肌肉质量比(r=0.327)和脂肪质量比(r=-0.302)呈正相关和负相关,分别。深度阻滞持续时间与任何评估变量均无相关性。
结论:在肌肉质量比和实现深度阻滞所需的罗库溴铵剂量之间没有检测到相关性。
BACKGROUND: Deep neuromuscular blockade (NMB) has benefits in various surgical procedures, however, precise quantitative neuromuscular monitoring is crucial for its proper maintenance and recovery. Neuromuscular blocking agent dosage relies on actual body weight (ABW), but this varies among individuals. Therefore, this
study hypothesizes that there is a correlation between the rocuronium requirement for deep NMB and muscle mass ratio measured by bioelectric impedance analysis.
METHODS: Ninety adult female patients undergoing laparoscopic operation were enrolled in this
study. Muscle and fat masses were assessed using a body composition analyser. Deep NMB, defined as a post-tetanic count of 1-2, was maintained through the continuous infusion of rocuronium. The primary outcome involves determining the correlation between the rocuronium dose required for deep NMB and the muscle mass ratio. Conversely, secondary outcomes included assessing the relationship between the rocuronium dose for deep NMB and fat mass ratio, and ABW. Additionally, we investigated their relationship with rocuronium onset time and profound blockade duration.
RESULTS: No relationship was observed between the muscle mass ratio and rocuronium dose required for maintaining deep NMB (r = 0.059 [95% CI = 0.153-0.267], p = 0.586). Fat mass ratio and ABW showed no correlation with the rocuronium dose, whereas rocuronium onset time was positively correlated with muscle mass ratio (r = 0.327) and negatively correlated with fat mass ratio (r = -0.302), respectively. Profound blockade duration showed no correlation with any of the assessed variables.
CONCLUSIONS: No correlation was detected between muscle mass ratio and the rocuronium dose required to achieve deep NMB.