摘要
目的研究年龄对持续输注罗库溴铵后肌松驰恢复的影响。方法纳入60例全身麻醉手术患者，按年龄分成4组。≤44岁组（12例）；45～59岁组（18例）；60～74岁组（15例）：≥75岁组（15例）。采用全程静脉麻醉，应用四个成串刺激（TOF）监测肌松深度。全麻诱导采用罗库溴铵0.6 mg/kg，术中静脉泵注罗库溴铵0.3～0.6 mg·kg－1·h－1，维持T1在10%～20%之间，临近手术结束停止泵入，记录各组恢复指数（RI）、TOFr 70%和TOFr 90%恢复时间、平均用药量。结果≥75岁组患者RI、TOFr 90%恢复时间、TOFr 70%恢复时间[（28.9±10.0）、（59.8±12.1）min、（38.6±10.6）min]较≤44岁组患者[（21.4±7.0）、（40.2±11.0）min、（27.6±10.0）min]延长（t＝2.38、4.50、3.12，P〈0.05或〈0.01）；较45～59岁组患者[（22.8±7.0）、（42.4±11.8）min、（28.7±9.2）min]延长（t＝2.14、4.42、3.10，P〈0.05或〈0.01）；较60～74岁组患者[（21.1±7.9、（41.0±9.8）min、（26.1±6.7）min]延长（t＝2.64、4.57、3.73，P〈0.05或〈0.01）。平均输注速率60～74岁组（0.33±0.06） mg·kg－1·h－1较≤44岁组（0.41±0.1）mg·kg－1·h－1降低（t＝2.73，P〈0.01）；≥75岁组（0.32±0.06）mg/kg.h较≤44岁组和45～59岁组（0.38±0.08）mg/kg.h均降低（t分别＝3.10、2.27，P〈0.05或〈0.01）。结论≥75岁组患者持续输注罗库溴铵后肌松恢复时间较其他患者延长；持续输注罗库溴铵后肌松恢复时间较单次注射延长，但仍具有一定规律；维持相同肌松深度，老年患者单位时间所需用药量减少。
ObjectiveTo investigate the influence of age on recovery from neuromuscular blocking after continuous infusion of rocuronium bromide.MethodsA total of 60 patients receiving general anesthesia were assigned to one of four groups according to age： ≤44 years old group （n=12）, 45-59 years old group （n=18）, 60-74 years old group （n=15）, and ≥75 years old group （n=15）. Total intravenous anesthesia was used for both induction and maintenance of anesthesia.The train-of-four （TOF） was applied for measuring acceleromyography.The induction of anesthesia was conducted with 0.6 mg/kg rocuronium bromide, and 0.3-0.6 mg·kg-1·h-1 rocuronium bromide was continuously intravenouoly infused until 30 minutes before the end of operation by a micro-pump to maintain T1 between 10-20%.Recovery index （RI）, recovery time of TOFr 70% and TOFr 90%, and the average infusion rate of the four groups were collected.ResultsThe RI, TOFr 70% recovery time, and TOFr 90% recovery time in the ≥75 years old group [28.9±10.0, （59.8±12.1） min, （38.6±10.6） min] were higher than those in the other three groups [≤44 years old group： 21.4±7.0, （40.2±11.0） min, （27.6±10.0） min; the 45-59 years old group： 22.8±7.0, （42.4±11.8） min, （28.7±9.2） min; the 60-74 years old group： 21.1±7.9, （41.0±9.8） min, （26.1±6.7） min] （all P〈0.05 or 0.01）. The average infusion rate for the ≤44 years old group （0.41±0.1） mg·kg-1·h-1 was higher than that for the 60-74 years old group （0.33±0.06） mg·kg-1·h-1 （P〈0.01）; The rate for the ≥75 years old group （0.32±0.06） mg·kg-1·h-1 was lower than that for the ≤44 years old group and that for the 45-59 years old group （0.38±0.08） mg·kg-1·h-1 （P〈0.05 or 〈0.01）.ConclusionsAfter continuous infusion of rocuronium bromide, patients aged 75 or over need more time to recover their myodynamia than younger people do.The myodynamia recovery time is longer after continuous bromide infusion than after a single d
作者
王斌
周俊飞
张欢
Wang Bin;Zhou Junfei;Zhang Huan(Department of Critical Care Medicine ,Peking University People＇s Hospital ,Beijing 100044 ,China;Department of Anesthesiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Chin;Department of Anesthesiology, Beijing Tsinghua Changgung Hospital,Beijing 102218 ,Chin)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2018年第4期441-444,共4页
Chinese Journal of Geriatrics
关键词
年龄因素
肌松驰
溴化物
Age factors
Muscle relaxation
Bromides
