Novosti
Khirurgii

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Year 2016 Vol. 24 No 2

ANESTHESIOLOGY & REANIMATOLOGY

A.L. LIPNITSKI, A.V. MAROCHKOV

PECULIARITIES OF CISATRACURIUM APPLICATION IN ELDERLY PATIENTS

ME "Mogilev Regional Hospital",
The Republic of Belarus

Objectives. To find out the impact of age on onset times; providing conditions for the tracheal intubation and duration of cisatracurium action.
Methods. The patients (n=78) undergone to laparoscopic cholecystectomy were enrolled in the prospective study. The patients were divided into four groups according to age: group 1 (n=18) 18-39 yrs old; group 2 (n=18) 40-49 yrs old; group 3 (n=21) 50 to 59 yrs old; and group 4 (n=21) – above 60 yrs old. All patients received cisatracurium 0,1-0,15 mg/kg. General anesthesia was maintained with inhalation of sevoflurane and bolus administration of fentanyl. A neuromuscular transmission was measured by kinemiography method.
Results. Onset time of cisatracurium action was significantly shorter in group 1 in comparison with groups 3 and 4: 216,5±88,6 c in group 1 in comparison with group 3 and 4: 284,8±87,4 and 306,0±140,5 c, respectively, p <0,05. All patients underwent tracheal intubation at the first attempt, duration was about 180 seconds.
Duration of action of cisatracurium was not differed between the groups: in group 1 –45,4±9,2 min, in group 2 – 47,6±9,6 min, in group 3 – 50,1±9,8 min, in group 4 – 46,9±9,8 min, p>0,1. Despite the absence of statistically significant differences in the duration of action, the recovery index of the neuromuscular block was significantly longer in groups 3 and 4 in comparison with groups 1 and 2 (group 1 – 12,9±3,3 min, group 2 – 12,6±3,1 min, group 3 – 17,7±6,6 min, group 4 – 17,8±5,9 min, p<0,05).
Conclusion. In elderly patients neuromuscular blockade occurs more slowly and neuromuscular transmission restored at the same time compared with young patients.

Keywords: muscle relaxants, cisatracurium, neuromuscular block, neuromuscular transmission, general anaesthesia, tracheal intubation, inhalation
p. 170-176 of the original issue
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Address for correspondence:
212002, the Republic of Belarus,
g. Mogilev, ul. B. Biruli, d. 12,
UZ "Mogilevskaya oblastnaya bolnitsa",
otdelenie anesteziologii i reanimatsii,
tel.office: 375 222 27-87-33,212002,
e-mail: Lipnitski.al@gmail.com,
Lipnitski Artur Leonidovich
Information about the authors:
Marochkov A.V. MD, professor, a head of anaesthesiology and intensive care unit of ME "Mogilev Regional Hospital".
Lipnitski A.L. A head of transplant-coordination unit of ME "Mogilev Regional Hospital".
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