title: The prolonged duration of rocuronium in Chinese patients.
abstract: 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 (T(1)) 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 T(1) 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 T(1) 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 microg/kg) and Chinese children (171+/-43 vs. 191+/-46 microg/kg) than in Caucasian adults and children, but the difference was not statistically significant. In adults, time to 25% T(1) 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.
authors.affiliation: Department of Anesthesia, Vancouver General Hospital Vancouver, British Columbia, Canada. lindacollins@bc.sympatico.ca
authors.forename: L M
authors.initials: LM
authors.lastname: Collins
authors.forename: J C
authors.initials: JC
authors.lastname: Bevan
authors.forename: D R
authors.initials: DR
authors.lastname: Bevan
authors.forename: G C
authors.initials: GC
authors.lastname: Villar
authors.forename: R
authors.initials: R
authors.lastname: Kahwaji
authors.forename: M F
authors.initials: MF
authors.lastname: Smith
authors.forename: F
authors.initials: F
authors.lastname: Donati
mesh_terms: D000293:Adolescent; D000328:Adult; D000732:Androstanols / Q000494:pharmacology; D044466:Asian People; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D003473:Neuromuscular Nondepolarizing Agents / Q000494:pharmacology; D000077123:Rocuronium; D009435:Synaptic Transmission / Q000187:drug effects; D013997:Time Factors; D044465:White People
chemical_list: D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D000077123:Rocuronium