不同年龄对顺式阿曲库铵肌松效应的影响  

Research of different ages on muscle relaxation effect of cisatracurium

作　　者：郭建荣[1] 卢慧勤[1] 廖丽君[1] 陈小非[1] 袁晓红[1] 金宝伟[1] 

机构地区：[1]宁波大学医学院附属李惠利医院麻醉科,宁波315040

出　　处：《中国临床药学杂志》2010年第6期338-342,共5页Chinese Journal of Clinical Pharmacy

摘　　要：目的观察不同年龄对顺式阿曲库铵肌松效应的影响。方法选择择期小儿或成人手术共90例,ASAⅠ～Ⅱ级,年龄1个月～59岁。按年龄分成3组:成人组(Ⅰ组)30例(16～59岁),儿童组(Ⅱ组)30例(2～12岁),幼儿组(Ⅲ组)30例(1个月～2岁);每组按首次给予顺式阿曲库铵的量(30、40、50μg·kg^(-1))再分成3个亚组,一共9组。采用咪达唑仑-丙泊酚-芬太尼进行麻醉诱导和维持,每例患者先随机给予一个首次剂量(30、40、50μg·kg^(-1))后,观察TOF刺激反应,当同等程度T_1反应连续重复3次时,记录T_1抑制程度,计算量-效关系曲线和ED_(95),再给每个患者静注顺式阿曲库铵使总量达到100μg·kg^(-1)。对T_1达100%抑制的患者观察顺式阿曲库铵的恢复时相。结果所有患者在抑制达到100%时完成气管插管,插管条件达到1级有83例(92.2%),达到2级有7例(7.8%);成人组、儿童组和幼儿组的ED_(95)分别为59.29、55.88、45.39μg·kg^(-1),3组患者ED_(95)值与年龄的增加呈正相关。成人组与儿童组比较,临床肌松维持时间、临床肌松有效作用时间、体内肌松作用时间较长(P<0.05),而与幼儿组比较,其以上3个作用时间较短(P<0.05),但3组间恢复指数无明显差异(P>0.05)。结论年龄对顺式阿曲库铵的肌松效应有一定影响。AIM To observe the influences of different ages on muscle relaxation effect of cisatraeurium. METHODS Ninty patients, ASA grade Ⅰ -Ⅱ , aged 1 month - 59 years, scheduled for elective surgery were included in the study. All patients were divided into 3 groups according to their ages：group Ⅰ , 30 patients aged 16 - 59 years; group Ⅱ , 30 patients aged 2- 12 years; group Ⅲ ,30 patients aged 1 month - 2 years. And the patients of each group were divided into 3 subgroups by first dose given. General anesthesia was induced and maintained with midazolam, propofoI and fentanyl. Every patient was given a first dose （ 30,40,50μg·kg-1） randomly, and the stimulating response of train-of-four （TOF） stimulation was observed. When the same degree of the first response （ T1 ） continuously repeating three times, the percentage depression of degree of T1, and compute the curve of dose-effect relations and ED95 were recorded. Then every patient was given eisatraeurium amount to 100μg· kg- 1. When T1 reached the maximum block effect （ 100% ）, recovery phase were observed. RESULTS When maximum block effect was 100%, the intubation was completed. Grade one was 83 patients （92.2%）,and grade two was 7 patients （7.8%）.The values of ED95 of all patients were positive con＇elated with the increase of age. The value of ED95 of group Ⅰ , group Ⅱ and group m were 59.29,55.88 and 45.39 μg·kg- 1, respectively. There were significant differences of clinical duration and total duration of action between the 3 age of groups （ P 〈 0.05 ）, but there were no significant differences of the recovery index between the 3 age of groups （ P 〉 0.05 ）. CONCLUSION Age could significandy affect the music relaxation effect of cisatraeurium.

关 键 词：顺式阿曲库铵 量-效关系 恢复时相 年龄 

分 类 号：R614[医药卫生—麻醉学]