Abstract
Aim: To establish a population pharmacokinetic modeling of rocuronium in
geriatric patients undergoing surgery. Methods: Blood samples were
collected after administration of rocuronium and the relevant datas were
collected. The plasma concentrations of rocuronium were determined by
UPLC-MS/MS method. The collection time of the sample is set as the
independent variable and the plasma concentration of rocuronium as the
dependent variable; all the significant effects were included in
covariates. The covariates affecting the pharmacokinetic parameters of
rocuronium in geriatric were quantitatively investigated through the
nonlinear mixed effect model by Phoenix WinNonlin 8.3 software. Results:
The final model is consistent with the three-compartment model, and the
residual model is proportional as residual model. The final model
formula is as follows:
V=tvV*exp(nV),V2=tvV2,V3=tvV3;Cl=tvCl*ALB∧dCldALB*Urea∧dCldUrea*exp(nCl),Cl2=tvCl2,Cl3=tvCl3.式中tvV=1.313L,tvV2=0.762L,tvV3=1.043L,tvCl=0.041L/h,tvCl2=3.238L/h,tvCl3=0.618L/h,dCldALB=1.015,dCldUrea=0.360.The
final model shown that ALB and Urea are covariates that could affect the
clearance rate of pharmacokinetic central Compartment. The validation
and prediction results had shown a good stability. Conclusion: The
results suggest that ALB and Urea might affect rocuronium clearance
rate. Pharmacokinetic parameters can be personalized according to the
actual situation of patients, which can provide reference for the
adjustment of rocuronium medication and pharmaceutical care plan in
clinical treatment of geriatric surgery, to ensure the safety and
postoperative recovery of geriatric during operation.