摘要
目的探讨顺式阿曲库铵应用于小儿的肌松效应。方法择期手术患儿180例,ASAⅠ或Ⅱ级,按三个年龄段分为婴儿组(Ⅰ组)、幼儿组(Ⅱ组)和儿童组(Ⅲ组),每组再分别按2ED95或3ED95的剂量分组,共6组(Ⅰ2、Ⅰ3、Ⅱ2、Ⅱ3、Ⅲ2、Ⅲ3),每组30例。连续监测ECG、SpO2、PETCO2、HR及拇内收肌诱发肌颤搐反应的变化。于5s内单次静脉注入顺式阿曲库铵0.10mg/kg或0.15mg/kg,待四个成串刺激(TOF)的T1为0时行气管插管,并对插管条件进行评级。观察阻滞起效时间、TOF无反应期、阻滞维持时间、肌松恢复指数及体内作用时间。结果Ⅰ3、Ⅱ3、Ⅲ3组起效时间显著短于Ⅰ2、Ⅱ2、Ⅲ2组(P<0.05),且Ⅰ2和Ⅰ3较其他组起效时间明显缩短(P<0.05)。Ⅰ3、Ⅱ3、Ⅲ3组气管插管条件为优的比率明显高于Ⅰ2、Ⅱ2、Ⅲ2组(P<0.05)。Ⅰ3、Ⅱ3、Ⅲ3组的TOF无反应期、阻滞维持时间、体内作用时间明显长于Ⅰ2、Ⅱ2、Ⅲ2组(P<0.05);Ⅰ2组TOF无反应期、阻滞维持时间、体内作用时间明显长于Ⅱ2、Ⅲ2组(P<0.05);Ⅰ3组TOF无反应期、阻滞维持时间、体内作用时间明显长于Ⅱ3、Ⅲ3组(P<0.05)。但是肌松恢复指数在各组差异无统计学意义。结论顺式阿曲库铵3ED95诱导剂量应用于婴、幼儿和儿童均是安全有效的,其起效和插管条件均优于2ED95。且婴儿较年长儿更为敏感。肌松恢复时间与剂量、年龄无关。
Objective To study the pharmacodynamic features of cisatracurium in children. Methods One hundred and eighty patients were randomized to group Ⅰ , group Ⅱ and group Ⅲ. Each group was subdivided according to the dose of cisatracurium, 0. 10 mg/kg （2ED95） or 0.15 mg/kg （3ED95） into group Ⅰ2, Ⅰ3, Ⅱ2,Ⅱ3, Ⅲ2, Ⅲ3 （n=30）. ECG, SpO2,PETCO2, HR and neuromuscular blockade were monitored. Intubation conditions were assessed when T1 was zero after cisatracurium administration using a 4-part scale. The onset time, TOF no reaction period, duration of action, recovery index, and hemodynamic responses were recorded. Results The onset times of group Ⅰ 3, Ⅱs and Ⅲ3 were 102.5 s, 178.8 s and 185.5 s, which were significantly shorter than those of groupⅠ 2, Ⅱ2 and Ⅲ2（118.8 s, 246.8 s and 250.2 s） （P〈0.05）. The percentages of patients with excellent intubation condition in group Ⅰ3, Ⅱ3 and Ⅲ3 were 90%, 90%, and 80%, which were markedly higher than those in group Ⅰ2 , Ⅱ 2 and Ⅲ2 （70%, 60%, 60%）. TOF no reaction period and duration of action were longer in group Ⅰ3, Ⅱ3 and Ⅲ3 than those in group Ⅰ2, Ⅱ2 and Ⅲ2 There was no any significant difference in recovery index among the six groups. Conclusion Cisatracurium 0. 15 mg/kg produces quicker onset time and acceptable intubation conditions in the great majority of infants, baby and children than 0. 10 mg/kg. Infants are more sensitive to cisatracurium with faster onset time and longer duration of action than children, but recovery index is independent on the dosage and age.
出处
《临床麻醉学杂志》
CAS
CSCD
2007年第10期821-823,共3页
Journal of Clinical Anesthesiology
关键词
顺式阿曲库胺
药效学
小儿
Cisatracurium
Pharmacodynamics
Children
