肥胖对女性患者罗库溴铵剂量-效应曲线的影响  

Effects of obesity on dose-response curve of rocuronium in female patients

作　　者：王士朝[1] 黄立宁[1] 康荣田[1] 

机构地区：[1]河北医科大学第二医院麻醉科,石家庄市050000

出　　处：《临床麻醉学杂志》2017年第1期33-36,共4页Journal of Clinical Anesthesiology

基　　金：中华医学会临床医学科研专项基金-默沙东肌松研究项目(13081410526)

摘　　要：目的观察肥胖对女性患者罗库溴铵剂量-效应曲线的影响,并计算肥胖女性患者罗库溴铵的95%有效剂量(ED95)。方法选择择期行全身麻醉女性患者80例,年龄18~45岁,ASAⅠ或Ⅱ级,手术时间<1.5h。根据BMI 20~25kg/m2和30~35kg/m2分为N组与B组,每组40例。两组患者根据随机数字表法各分为0.075、0.1、0.15、0.3 mg/kg四个剂量组,分别为N1~N4组和B1~B4组。麻醉诱导同时开启注射泵,待患者意识消失后,校对肌松监护仪,启动TOF模式,N1~N4组和B1~B4组分别给予罗库溴铵单次剂量0.075、0.1、0.15、0.3mg/kg。记录各组患者给予罗库溴铵的首次剂量、第一个肌颤搐反应(T1)的最大抑制程度和肌松药起效时间。采用直线回归法建立罗库溴铵量效关系回归方程,计算N组和B组患者的ED50和ED95及其95%CI。结果 N组和B组的量效关系回归方程分别为Y1=3.464X1-2.230和Y2=3.843X2-2.750。B组ED50、ED75、ED90、和ED95分别为0.103、0.145、0.201和0.251 mg/kg明显小于N组0.122、0.176、0.254和0.324mg/kg(P<0.05)。N组与B组T1最大抑制程度均随药量的增加而增大(P<0.05)。结论肥胖影响年轻女性患者罗库溴铵的量效曲线,使其对罗库溴铵的敏感性增强,肥胖女性罗库溴铵ED95为0.251mg/kg。Objective To observe the effects of obesity on dose-response curve of rocuronium in female patients and calculate ED95 of rocuronium.Methods Eighty female patients,aged 18-45 years,falling into ASA gradeⅠ orⅡ,schedualed for elective surgery under general anesthesia,undergoing surgery less than 1.5h,were included in the study.The patients with body mass index of 20-25kg/m2 as group N were randomized to divided group N1,group N2,group N3 and group N4.Another 40 patients with body mass index of 30-35kg/m2 as group B were randomized to divided group B1,group B2,group B3 and group B4.When the first twitch height of TOF（T1）was 100%,groups N1-N4 and groups B1-B4 patients were injected rocuronium 0.075,0.1,0.15,0.3 mg/kg respectively.The first dose of rocuronium in each group,T1 maximum inhibition degree and onset time were recorded.The relationship between probit-transformed depression of T1 and the logarithm dose of rocuronium was analyzed by linear regression.ED50 and ED95of rocuronium in obese and normal body weight patients were calculated.Results Dose-response curve equation of each group were Y1 =3.464X1-2.23 and Y2=3.843X2-2.750respectively（P〈0.05）.The ED50 and ED95（95%CI）of rocuronium were 0.122（0.092-0.165）mg/kg and 0.324（0.242-0.433）mg/kg in group N,and were 0.103（0.078-0.133）mg/kg and 0.251（0.193-0.326）mg/kg in group B.Conclusion Obesity significantly affects the dose-response curve of young women and can enhance the sensitivity of them to the rocuronium.The ED95 of obese patients is 0.251mg/kg.

关 键 词：肥胖 肌松监测 罗库溴铵 剂量-效应曲线 

分 类 号：R614[医药卫生—麻醉学]