摘要
目的探讨顺苯磺阿曲库铵应用于不同年龄患者的肌松效果。方法择期手术患者180例，ASA分级Ⅰ～Ⅱ级，按年龄分为50～60岁组（Ⅰ组）、61～70岁组（Ⅱ组）和70岁以上组（Ⅲ组），每组再分别按2倍95％有效量（ED95）或3倍E风分组，共六组（Ⅰ2、Ⅰ3、Ⅱ2、Ⅱ3、Ⅲ2、Ⅲ3组），每组各30例。连续监测ECG、SpO2、呼气末二氧化碳分压（PICTCO2）、HR及拇内收肌诱发肌颤搐反应的变化。患者入睡后开启电刺激，将肌颤搐的高度调节至100％，稳定后单次静脉注入2倍ED95或3倍ED。的顺苯磺阿曲库铵，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、肌松恢复时间及体内作用时间。结果Ⅰ3、Ⅱ3、Ⅲ3组患者插管条件为优的比率（93％、90％、80％）明显高于Ⅰ2、Ⅱ2、Ⅲ2组（67％、60％、60％），P〈0．05。Ⅰ3、Ⅱ3、Ⅲ3组阻滞起效时间显著短于Ⅰ2、Ⅱ2、Ⅲ2组（P〈0．05），且Ⅰ2组和Ⅰ3组较其他组阻滞起效时间明显缩短（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）；Ⅱ2、Ⅲ2组TOF无反应期、阻滞维持时间、体内作用时间明显短于Ⅰ2组（P〈0．05）；Ⅱ3、Ⅲ3组TOF无反应期、阻滞维持时间、体内作用时间明显短于Ⅰ3组（P〈0．0S）；但是肌松恢复时间各组比较差异均无统计学意义。结论顺苯磺阿曲库铵3倍ED95应用于不同年龄患者均是安全有效的，其起效和插管条件均优于2倍ED95肌松恢复时间与剂量、年龄关系不大。增龄对单次静脉注射顺苯磺阿曲库铵的药效学无明显影响。
Objective To study the pharmacodynamics features of cisatracurium besylate in different age patients. Methods One hundred and eighty patients were randomized to group Ⅰ （50-60 years old）,gmup Ⅱ （61-70 years old）and group Ⅲ（above 70 years old）.Each group was subdivided according to the dose of cisatracurium besylate, 0.10 mg/kg （2ED95） or 0. 15 mg/kg （3ED95） into group Ⅰ2, Ⅰ 3, 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 besylate administer ration using a 4-part seale.The onset time, TOF no reaction time, duration time, recovery time and hemodynamic response time were recorded. Resuits The onset times of group Ⅰ 3, Ⅱ 3 and Ⅲ 3 were significantly shorter than those of group 12, Ⅱ2 and Ⅲ 2 （P 〈 0.05）.The percentages of patients with excellent intubation condition in group Ⅰ3, Ⅱ3 and Ⅲ 3 were 93%, 90%, and 80%, which were markedly higher than those in group Ⅰ 2, Ⅱ2 and Ⅲ2 （67%, 60%, 60%）. TOF no reaction time and duration time were longer in group Ⅰ3,Ⅱ 3 and Ⅲ3 than those in group Ⅰ2, Ⅱ2 and Ⅲ 2. There was no significant difference in muscle chalasis among the six groups. Conclusions Cisatracurium besylate 0. 15 mg/kg produces quicker onset time and acceptable intubation conditions in the different age patients than 0.10 mg/kg. Recovery time is independent on the dosage and age. Aging has no influence on the pharmacodynamics of single injection of cisatracurium besylate.
出处
《中国医师进修杂志》
2008年第12期21-23,共3页
Chinese Journal of Postgraduates of Medicine
关键词
年龄
顺苯磺阿曲库铵
药效学
Age
Cisatracurium besylate
Pharmacodynamics
