病态肥胖患者的罗库溴铵使用剂量  

Nuromuscular Pharmacodynamics of Rocuronium in Morbidly Obese Patients

作　　者：葛云芬[1] 严美娟[1] 

机构地区：[1]浙江省人民医院麻醉科,杭州310014

出　　处：《中国药学杂志》2011年第12期960-962,共3页Chinese Pharmaceutical Journal

摘　　要：目的研究不同剂量罗库溴铵在腹腔镜袖套状胃大部切除术的女性病态肥胖患者中的效用。方法 48名病态肥胖女性患者(体重指数>40 kg.m-2),行腹腔镜袖套状胃大部切除术,随机分成3组,分别用罗库溴铵0.6 mg.kg-1,Ⅰ组16例,根据实际体重;Ⅱ组16例,根据理想体重;Ⅲ组16例,根据理想体重加上20%超标体重。应用丙泊酚和瑞芬太尼诱导后,注射罗库溴铵,记录罗库溴铵的起效时间?T1恢复到25%的时间和恢复指数。结果罗库溴铵的起效时间在Ⅰ组较Ⅲ组和Ⅱ组明显缩短(P<0.05);3组的插管评分差异无显著性意义;T1恢复到25%的时间,Ⅰ组较Ⅱ组和Ⅲ组明显延长(P<0.05),Ⅱ组与Ⅲ组相比,明显缩短(P<0.05)。恢复指数在Ⅰ组与Ⅱ组及Ⅲ组相比,有延长趋势(P<0.05)。结论病态肥胖患者,在丙泊酚和瑞芬太尼诱导和维持下,罗库溴铵根据理想体重给药,可以获得优质的气管插管条件,且作用时效明显缩短。OBJECTIVE To compare the onset time, conditions for tracheal intubation, and duration of action of rocuronium in morbidly obese patients undergoing laparoscopic sleeve gastreetomy. METHODS Forty-eight mobidly obese patients scheduled for laparoscopic sleeve gastrectomy under propofol-remifentanil anesthesia were randomized into 3 groups. The patients received roeuronium （0.6 mg · kg^-1） based on real body weight （ group I, n =16）, ideal body weight （ group Ⅱ, n=16）, or ideal body weight plus 20% of excess weight （ group Ⅲ, n = 16）. Propofol and remifentanil were administered both according to real body weight. RESULTS The median onset time was 52.1, 88.5, and 85.1 s in group I , Ⅱ, and Ⅲ, respectively （ P 〈 0.05 for comparison of the group I and Ⅱ ）. The median durations of action were 51.6, 23.6, and 29.8 min in group I , Ⅱ, and Ⅲ, respectively （ P 〈 0.05 for comparison of group I and Ⅱ , and group Ⅱ and Ⅲ. There were no significant differences in intubation conditions 90 s after administration of roeuronium. CONCLUSION In mobidly obese patients undergoing laparoscopic sleeve gastreetomy, roeuronium dosed according to ideal body weight provided a shorter duration of action without significantly prolonged onset time or poor conditions for tracheal intubation.

关 键 词：病态肥胖 罗库溴铵 腹腔镜下袖套状胃大部切除术 

分 类 号：R971.8[医药卫生—药品]