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  Česky / Czech version Anest. intenziv. Med., 2006, 17, č. 5, s. 241-245.
 
Duration of rocuronium-induced neuromuscular block predicted by its dose and onset time: a prospective study 
Adamus M.1, Adamus P.2, Bělohlávek R.3, Vujčíková M.1, Janásková E.1 

1Klinika anesteziologie a resuscitace, LF Univerzity Palackého a Fakultní nemocnice, Olomouc 2Rapid System, s. r. o., Olomouc 3Katedra informatiky, PřF Univerzity Palackého, Olomouc
 


Summary:

       Objective: Following a bolus dose of rocuronium, the average duration of neuromuscular block until 25% recovery (= clinical duration) can be preďicteď by the dose-duration relationship. In the present study we investigated whether the predictive power could be improved by the adďition of another inďepenďent variable - onset time. Design: Clinical, prospective, randomized, controlled study. Settings: Department of Anaesthesiology and Intensive Care, University Hospital, Olomouc. Materials andMethods: Following local ethics committee approval and obtaining informed consent, 350 pati-ents scheduleď for elective surgery unďer total intravenous anaesthesia with tracheal intubation were randomized into 7 groups with different rocuronium doses administered (0.30; 0.45; 0.60; 0.75; 0.90; 1.05; 1.20 mg . kg-1, respectively). For each consecutive patient the onset time for 95% depression of T, anď clinical duration until 25% recovery were determined.To predict clinical duration for different values of two indepenďent variables (ďose anď onset time), statistical analyses were performeď by simple anď multiple linear regression (least-square method).The squared correlation coefficient (r2) was ušed as the primary criterion for the evaluation of each model. In aďďition, the possible useful effect of ďifferent transformatons of the variables was studied. Results: The duration of action was better preďicteď by dose (r2 = 0.64) than by onset time (r2 = 0.59). The predictability of clinical duration was improved by combining the two independent variables (dose and onset time) in a multiple regression model (r2 = 0.68). The explanatory power was further increased when using the logarithm of clinical duration as the dependent variable (r2 = 0.72). Conclusion:7he duration of rocuronium-induced neuromuscular block can be predicteď more precisely by the combined use of dose and onset time than by dose (or onset time) alone.The addition of an individual response parameter, the onset time, improved the prediction of the duration of action.

        Key words: neuromuscular block - rocuronium - clinical duration - onset time - simple and multiple linear regression analysis
       

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