比较罗库溴铵按体表面积与实际体重间断静注给药的药效学  

Comparison of pharmacodynamics of rocuronium administered by intermittent bolus injection according to body surface area and real body weight

作　　者：周翠云[1] 邢祖民[2] 磨凯[1] 刘中杰[1] 徐世元[1] 

机构地区：[1]南方医科大学珠江医院麻醉科,广州市510282 [2]顺德第一人民医院麻醉科,广东省佛山市528300

出　　处：《实用医学杂志》2014年第6期959-962,共4页The Journal of Practical Medicine

摘　　要：目的：比较罗库溴铵（ROC）按体表面积与实际体重间断静注给药的药效学特点及个体化差异，为临床如何合理应用ROC提供参考。方法：择期全麻手术患者42例，ASAI～Ⅱ级，随机分成BSA组和RBw组．每组21例。采用TOF．Watchsx肌松监测仪以TOF刺激方式刺激尺神经，监测拇内收肌的收缩反应。全麻诱导分别按体表面积和实际体重静注2倍ED95ROC（BSA组按16．64mg／m。计算，RBW组按0．6mg／kg计算），当T1恢复至10％时，重复间断静注0．5倍ED95，剂量，预计手术结束前30min停止追加ROC。记录肌松维持及恢复过程，并记录ROC的用量。结果：两组肌松阻滞时效各指标差异无统计学意义（P〉0．05）。BSA组ROC单次追加药量及维持用药量均显著小于RBW组（P〈0．05）。与RBW组相比，BSA组在单次追加药量、加药间隔时间、药理作用时间、TOFr恢复至0．7的时间个体间变异度更小（P〈0.05）。结论：ROC按体表面积间断静注给药可获得与按实际体重给药相似的肌松效应，减少肌松药用量，亦可减少肌松阻滞时效的个体差异。Objective To compare the pharmacodynamics of rocuronium intermittently administered according to body surface area and real body weight and individual differences. Method Forty-two patients undergoing elective surgery under general anesthesia were enrolled into the body surface area group （BSA group） and the real body weight group （RBW group）, with 21 patients in each group. The patients in the two groups were indueed with 2ED95 of rocuronium according to body surface area and real body weight （16.64 mg/m： in BSA group; 0.6 mg/kg in RBW group）. Whenever T1 recovered to 10%, a dosage of 0.5ED95 was administred repeatedly for 30 rain before the end of the operation. The time of neuromuscular blockade and recovery of muscle relaxation were recorded, and the dosage of rocuronium was also recorded. Results No significant difference in each index of neuromuscular block time-effect was found between the two groups （P 〉 0.05）. The single dosage and maintainance amount of muscle relaxation were less in the BSA group than that in RBW group （P 〈 0.05）. Compared with the RBW group, the single dosage, dosing intervals, pharmacological duration and the time TOFr recovered to 0.7 between the different individuals were less in the BSA group （P 〈 0.05）. Conclusion The intermittent administration of rocuronium can maintain the same clinical efficacy according to body surface area as that according to real body weight, with significantly less dosageand reducing the differences of individuals in blockade time-effeet of muscle relaxation.

关 键 词：肌松药 罗库溴铵 体表面积 注射 静脉内 药效动力学 

分 类 号：R614[医药卫生—麻醉学]