摘要
目的研究不同年龄段婴幼儿静吸复合麻醉中应用顺苯磺酸阿曲库铵的肌肉松弛（肌松）时效，探讨顺苯磺酸阿曲库铵的合理使用剂量。方法静吸复合麻醉下行择期手术的婴幼儿100例，根据年龄段分为两组（每组50例）：A组（3-6个月），B组（7-36个月），再根据顺苯磺酸阿曲库铵负荷剂量[2ED95（95%有效量，95% effective dose）0.10 mg/kg，3ED95 0.15 mg/kg]各平均分为两个亚组（每组25例）：3-6个月患儿顺苯磺酸阿曲库铵负荷剂量0.10 mg/kg组（A0.10组）、3-6个月患儿顺苯磺酸阿曲库铵负荷剂量0.15 mg/kg组（A0.15组）、7-36个月患儿顺苯磺酸阿曲库铵负荷剂量0.10 mg/kg组（B0.10组）、7-36个月患儿顺苯磺酸阿曲库铵负荷剂量0.15 mg/kg组（B0.15组）。观察肌松时效指标[起效时间、临床作用时间、恢复指数（recovery index, RI）、肌颤搐（twich, Th）时间与4个成串刺激（train-of-four, TOF）恢复时间]、副作用情况。结果A组的起效时间明显短于B组（P〈0.05），高负荷剂量组（0.15 mg/kg）的起效时间明显短于低负荷剂量组（0.10 mg/kg）（P〈0.05）；4组患儿临床作用时间、TOF恢复时间比较，差异无统计学意义（P〉0.05）；4组间副作用情况比较，差异无统计学意义（P〉0.05）。结论婴幼儿的年龄与顺苯磺酸阿曲库铵的负荷剂量是影响肌松时效的关键因素。
Objective To study the muscular relaxant effect of doses of cisatracurium in infants and young children under combined intravenous-inhalational anesthesia, in order to optimize the dosage of cisatracurium.Methods This study enrolled one hundred infants and young children elected for operation under combined intravenous-inhalational anesthesia in our hospital. These cases were divided into group A（3-6 months old） and group B（7-36 months old）. Subjects in group A and group B were further divided into two subgroups receiving either 0.10 mg/kg or 0.15 mg/kg cisatracurium. Each subgroup had 25 cases. The muscular relaxant effect was evaluated by analyzing its onset time, clinical reaction time, recovery index（RI）, twich（Th） time and train-of-four（TOF） recovery time.Results The onset time of muscle relax in group A was significantly shorter than in group B（P〈0.05）, and in each group, the onset time of the effect of 0.15 mg/kg cisatracurium was significantly shorter than that of 0.10 mg/kg cisatracurium（P〈0.05）. The difference of clinical reaction time, recovery time and unfavorable effects had no statistical significance among four subgroups（P〉0.05）.Conclusions The age of infants and young children and the loading doses of cisatracurium was the key factors to determine the muscular relaxant effect.
作者
王薇
杨鹏
Wang Wei;Yang Peng(Department of Anesthesiology,the First People＇s Hospital of Zigang City,Zigong 643000,Chin)
出处
《国际麻醉学与复苏杂志》
CAS
2018年第7期645-649,共5页
International Journal of Anesthesiology and Resuscitation
关键词
婴幼儿
静脉-吸入复合麻醉
肌肉松弛时效
顺苯磺酸阿曲库铵
Infants and young children
Combined intravenous and inhalational anesthesia
Muscular relaxant effect
Cisatracurium
