Elective Surgery Clinical Trial
Official title:
An Observational Study of Rocuronium 0.6 mg/kg Comparing Onset Time, Duration of Action and Effect on Intubation Conditions in Younger (18 - 40 Years) and Elderly Patients (> 80 Years)
The number of elderly patients (>80 years) is increasing and a large proportion of these
patients will require surgery and anaestheasia within the next decades.
During anaesthesia NMBAs are used to facilitate tracheal intubation, from former studies it
is reported that elderly patients are more sensitive towards muscle relaxants.
It is unknown if there are differences in onset times of NMBAs between younger patients and
elderly.
The aim of this study is to determine the onset time, duration of action and effect on
intubating conditions for rocuronium 0.6 mg/kg in patients aged 18-40 years and in patiens
>80 years. The hypothesis of this study is that rocuronium administered in elderly patients
(>80 years) has a longer onset time compared to younger patients.
The number of elderly patients (>80 years) is increasing and a large proportion of these
patients will require surgery and anesthesia within the next decades. Elderly patients are at
higher risk of major morbidity and mortality and are characterized by a reduction in cardiac
output, liver function and renal function. These physiological changes influence
pharmacodynamics and pharmacokinetics of drugs administered during anesthesia as for example
neuromuscular blocking agents (NMBA).
During anesthesia NMBAs are used to facilitate tracheal intubation, establish muscle
relaxation and suppress reflexes during surgery. Elderly patients are more sensitive towards
muscle relaxants. In addition studies have reported prolonged duration of NMBAs and an
observational study found that elderly patients are more prone to experience residual
neuromuscular blockade in the post anesthesia care unit. However, most studies have been
conducted in elderly below 80 years.
It is unknown if there are differences in onset times of NMBAs e.g. rocuronium, mivacurium
and cisatracurium between younger patients and elderly. Onset time for NMBAs in the elderly
is of importance since it may influence intubating conditions, especially during rapid
sequence induction. For example it is unknown in the elderly if an increased dose of NMBA
reduces the onset time. There remains a need for studies investigating the optimal dose for
facilitating intubation in the elderly, both during rapid sequence induction and during
elective procedures.
The aim of this study is to determine the onset time, duration of action and effect on
intubating conditions for rocuronium 0.6 mg/kg in patients aged 18-40 years and in patients
with age > 80 years. The hypothesis of this study is that rocuronium administered in elderly
patients (>80 years) has a longer onset in the elderly compared to younger patients.
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