女性患者不同效应室靶浓度罗库溴铵肌松效应的比较  

Neuromuscular blockade induced by different target effect-site concentrations of rocuronium in female patients

作　　者：张化[1] 张卫[1] 樊肖冲[1] 赵璞[1] 

机构地区：[1]郑州大学第一附属医院麻醉科,450052

出　　处：《中华麻醉学杂志》2012年第6期759-761,共3页Chinese Journal of Anesthesiology

摘　　要：目的比较女性患者不同效应室靶浓度罗库溴铵的肌松效应。方法选择女性甲状腺或乳腺手术患者120例，ASA分级I或Ⅱ级，年龄40～55岁，BMI18～22kg／H12。采用随机数字表法，将患者随机分为4组（n=30），A组、B组、C组麻醉诱导时罗库溴铵效应室靶浓度（ce）为3．5μg／ml，麻醉维持Ce分别为1．0、1．2、1．4μg／ml；D组麻醉诱导时Ce为3．8μg/ml，麻醉维持Ce为1．2μg／ml。记录肌松起效时间、恢复时间、恢复指数、罗库溴铵用量；评估气管插管条件和术中肌松程度。结果与A组比较，B组、C组和D组肌松程度深，肌松满意率高（P〈0．05），B组、C组、D组间上述指标差异无统计学意义（P〉0．05）。与A组、B组和C组比较，D组起效时间最短（P〈0．05）。与C组比较，A组、B组和D组罗库溴铵用量、恢复时间、恢复指数降低（P〈0．05）。B组和D组罗库溴铵用量、恢复时间、恢复指数比较差异无统计学意义（P〉0．05）。结论麻醉诱导时罗库溴铵Ce3．8μg／ml，麻醉维持Ce1．2μg／ml，可产生满意的肌松条件，且有利于术后肌松恢复，是一种适用于女性患者的TCI给药方案。Objective To compare the neuromuscular blockade induced by different target effect-site concentrations （Ces） of roeuronium in female patients. Methods One hundred and twenty ASA I or IT female patients, aged 40-55 yr,with body mass index 18-22 kg/m^2, scheduled for elective thyroid or breast surgery under general anesthesia, were included in the study. Anesthesia was induced with midazolam 0.1 mg/kg and＇fentanyl 5 Mg/kg. Target-controlled infusion of rocuronium was started to facilitate tracheal intubation as soon as the patients lost consciousness. The patients were randomly divided into 4 groups （ n = 30 each） ： A, B, C and D groups. In groups A, B, and C, the target Ce of rocuronium was set at 3.5 μg/ml during induction of anesthesia and at 1.0, 1.2 and 1.4μg/ml respectively during maintenance of anesthesia. In group D, the target Ce of rocuronium was set at 3.8μg/ml during induction of anesthesia and at 1.2 μg/ml during maintenance of anesthesia. The onset time （time from the beginning of target-controlled infusion of rocuronium to T1 = 5 % of the control twitch）, recovery time （when T1 returned to 25% of the control twitch）, recovery index （the time for T1 to return from 25% to 75% of the control twitch）, and the total amount of rocuronium consumed during operation were recorded. The intubation conditions and degree of muscle relaxation during operation were assessed. Results Neuromuscular block during operation was significantly better and the rate of satisfactory neuromuscular block was significantly higher in groups B, C and D than in group A （ P 〈 0.05）. Onset time was significantly shorter in group D than in groups A, B and C （ P 〈 0.05） . Compared with group C, the total amount of rocuronium consumed during operation, recovery time and recovery index were significantly decreased in groups A, B and D （P 〈 0.05） . There was no significant difference in the total amount of rocuronium consumed during operation, recovery time and recovery index be tween groups B

关 键 词：雄甾烷醇类 药物释放系统 性别因素 

分 类 号：R614[医药卫生—麻醉学]