The gender influence on the pharmacodynamic parameters of cis-atracurium in tuberculosis patients

LIU Min-qiang; HE Jun-yong; WANG Hua; ZHANG Pei-pei; MA Ming-fei; LI Ren-zai; HE Ren-liang

Abstract：Objective To investigate the pharmacodynamic parameters of cis -atracurium in tuberculosis patients with different gender .Methods Eighty patients ( ASAⅠor Ⅱ) received selective general anesthesia were enrolled in this study.They were divided into tuberculosis group (Group T, n=40) andnon -tuberculosis group (Group N, n=40), whom were subsequently subdivided into male (TM and NM) and female (TF and NF) subgroups.All patients re-ceived an intravenous injection of midazolam (0.1 mg/kg), fentanyl (4μg/kg) and propofol (with target plasma concen-tration of 1-4 μg/mL).The neuromuscular block level was measured by neuromuscular transmission monitor after pa -tients'consciousness disappeared .With an intravenous 0.15 mg/kg of cis -atracurium, the responses were defined in terms of the percentages of maximum suppression at the first contraction ( T1 ) of the train-of-four of the adductor polli-cis muscle.Endotracheal intubation was conducted when T 1 fell to its lowest and repeated no less than 3 times.The onset time, the maximum inhibition of T 1 , the clinical effect time , the recovery index , the pharmacological effect time and the endotracheal intubation conditions were recorded .MAP and HR were measured before anesthesia induction ( t0 ) , and 5 min ( t1 ) , 15 min ( t2 ) , 30 min ( t3 ) , 45 min ( t4 ) , and 1 h ( t5 ) after general anesthesia .Results The onset time of cis-atracurium in Group TF was significant shorter than that in Group TM , with significantly longer clinical effect time ( P<0.01).However, there was no significant difference between Group NM and NF (P>0.05).Compared with Group N, the clinical effect time and pharmacological effect time in Group T were significantly shorter (P<0.05), while there was no significant difference in the onset time , the maximum inhibition of T 1 , the clinical effect time , the recovery index , or the pharmacological effect time between the two groups (P>0.05).No significant difference was found in the endotrache-al intubation conditions or hemodynamics before or after induction among the four subgroups ( P>0.05 ) .Conclusion Female tuberculosis patients are more sensitive to a single intravenous injection of cis -atracurium, presenting with short-ened onset time , and lengthened clinical effect time and pharmacological effect time .