Rocuronium Versus Vecuronium For Neuromuscular Block in the Geriatric Patients

Abstract

There are physiologic changes which accompany the aging process (over 65 years) including: a decrease in total body water, an increase in total body fat, a decrease in hepatic and renal blood flow, and a decrease in cardiac reserve. These factors account for the altered responses of the eldrely to muscle relaxants. The geriatric patient has age-related prolongation of the elimination phase of plasma half time of a drug, also • reduction in rate of clearance or increase in volume of distribution, explaining prolonged duration of action of drugs in these patients.

This study included 100 ASA I and II patients scheduled for elective operations lasting more than 30 minutes. They were randomized into one of four equal groups according to the age (adult and geriatric) and the muscle relaxant (rocuronium or vecuronium). The doses of the muscle relaxant used for endotracheal intubation were 0.6mg/kg for rocuronium and O.lmg/kg for vecuronium.

The doses used for maintenance of mucle relaxation were 0.15mg/kg for rocuronium and 0.025mglkg for vecuronium.

Haemodynamic monitoring for heart rate and artrial blood pressure was done.

Neuromuscular monitoring was performed by train of four stimulation using Datex relaxograph with the evaluation of onset time,

duration of relaxation and recovery index. conditions was recorded.

Rating of intubating