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Departments of Anesthesia,
*Vancouver General Hospital and
British Columbia’s Children’s Hospital, University of British Columbia, Vancouver, British Columbia, and
Université de Montréal, Montréal, Québec, Canada
Address correspondence and reprint requests to Linda Collins, MB, BCh, BAO, FFARCSI, Department of Anesthesia, Vancouver General Hospital, Room 3200, 910 West 10th Ave., Vancouver, British Columbia, Canada V5Z 4E3. Address e-mail to lindacollins{at}bc.sympatico.ca
We compared the potency and duration of action of rocuronium in Chinese and Caucasian patients during general anesthesia. Thirty-six women (18 Caucasian and 18 Chinese) and 36 children (18 Caucasian and 18 Chinese) were evaluated during the administration of propofol/fentanyl anesthesia. Patients in each age group were randomized into three subgroups to receive single doses of 0.06, 0.12, or 0.18 mg/kg rocuronium (adults) or 0.12, 0.18, or 0.24 mg/kg rocuronium (children). Neuromuscular blockade was assessed by electromyography of the adductor pollicis after train-of-four (TOF) stimulation of the ulnar nerve. Dose response curves were constructed when maximum neuromuscular depression of the first twitch of the train (T1) was obtained. A second bolus dose of rocuronium was then administered to a total dose of 0.6 mg/kg. The times of spontaneous recovery to T1 10%, 25%, and 90% of control and to TOF 0.25, 0.50, and 0.70 were recorded. For both adults and children, recovery occurred later in Chinese than in Caucasian patients (P < 0.05 for T1 of 10%, 25%, 75%, and 90% and TOF to 0.7). The 50% effective dose was smaller in Chinese adults (125 ± 63 vs 159 ± 66 µg/kg) and Chinese children (171 ± 43 vs 191 ± 46 µg/kg) than in Caucasian adults and children, but the difference was not statistically significant. In adults, time to 25% T1 recovery was 43 ± 13 min in Chinese patients and 33 ± 10 min in Caucasian patients (P < 0.05). The corresponding values were more rapid for children: 30 ± 10 and 24 ± 6 min (P < 0.05). We conclude that the recovery from rocuronium neuromuscular blockade was longer in Chinese compared with Caucasian patients and in adults compared with children.
Implications: The potency of rocuronium does not differ between adults and children of Caucasian and Chinese origins. If tracheal intubating doses of 0.6 mg/kg IV are given, similar levels of neuromuscular blockade are expected but recovery will be longer by 29%–30% in Chinese compared with Caucasian children and adults.
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  T. Han, H. Kim, J. Bae, K. Kim, and J. A. J. Martyn Neuromuscular Pharmacodynamics of Rocuronium in Patients with Major Burns Anesth. Analg., August 1, 2004; 99(2): 386 - 392. [Abstract] [Full Text] [PDF]
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