性别因素对癫痫患者罗库溴铵肌松效应的影响  

Effect of gender on neuromuscular blockade of rocuronium in epileptics

作　　者：韩明明 刘自由 杨成伟 翟明玉 郑客松 王婷[1] 王勇[1] 孙丹丹[1] 李娟[1] Han Mingming;Liu Ziyou;Yang Chengwei;Zhai Mingyu;Zheng Kesong;Wang Ting;Wang Yong;Sun Dandan;Li Juan(Department of Anesthesiology,First Affiliated Hospital of University of Science and Technology of China Anhui Provincial Hospital,Hefei 230036,China)

机构地区：[1]中国科学技术大学附属第一医院,安徽省立医院麻醉科,合肥230036

出　　处：《中华麻醉学杂志》2020年第1期68-70,共3页Chinese Journal of Anesthesiology

基　　金：吴阶平医学基金会临床科研专项资助基金(320.6750.18182)。

摘　　要：目的评价性别因素对癫痫患者罗库溴铵肌松效应的影响。方法择期全身麻醉下行手术治疗的癫痫患者40例,年龄18~59岁,BMI 18.5~24.0 kg/m2,ASA分级Ⅱ或Ⅲ级。按照性别分为2组(n=20):男性组(M组)和女性组(F组)。采用肌松监测仪监测神经肌肉传导功能,于TOF模式(频率2 Hz、波宽0.2 ms、刺激电流70 mA,串间间隔12 s)刺激尺神经。麻醉诱导时静脉注射罗库溴铵0.8 mg/kg,当Tl达最大抑制时行气管插管,采用改良法评价气管插管条件。术中T1恢复至25%时,静脉注射罗库溴铵0.15 mg/kg。术毕T1恢复至50%时,静脉注射舒更葡糖钠2 mg/kg。记录罗库溴铵起效时间(Tonset)、高峰时间(Tpeak)、10%恢复时间(T10%)、10%~25%恢复时间(T10%~25%)、25%~50%恢复时间(T25%~50%)、50%~75%恢复时间(T50%~75%)、75%~90%恢复时间(T75%~90%)。于术毕T1恢复至25%和75%时分别采集外周静脉血3 ml,采用液相色谱-质谱联用法检测罗库溴铵血药浓度。计算单位时间体重罗库溴铵用量。结果2组患者Tonset、Tpeak、T10%、T10%~25%、T25%~50%、T50%~75%、T75%~90%、气管插管条件、各时点罗库溴铵血药浓度及单位时间体重罗库溴铵用量比较差异无统计学意义(P>0.05)。结论性别因素对癫痫患者罗库溴铵肌松效应无影响。Objective To evaluate the effect of gender on neuromuscular blockade of rocuronium in epileptics.Methods Forty American Society of Anesthesiologists physical statusⅡorⅢpatients,aged 18-59 yr,with body mass index of 18.5-24.0 kg/m2,scheduled for elective surgery for treatment of epilepsy under general anesthesia,were divided into 2 groups(n=20 each)according to gender:male group(group M)and female group(group F).Neuromuscular conduction function was monitored with a muscle relaxation monitor.Ulnar nerve was stimulated in TOF mode(frequency 2 Hz,wave width 0.2 ms,stimulation current 70 mA and interval 12 s).Rocuronium 0.8 mg/kg was injected intravenously during anesthesia induction,and endotracheal intubation was performed when Tl reached maximum inhibition.The conditions of endotracheal intubation were evaluated by the modified method.When T1 recovered to 25%during operation,rocuronium 0.15 mg/kg was intravenously injected.Sugammadex sodium 2 mg/kg was injected intravenously when T1 recovered to 50%after surgery.The onset time(Tonset),peak time(Tpeak),10%recovery time(T10%),10%-25%recovery time(T10%-25%),25%-50%recovery time(T25%-50%),50%-75%recovery time(T50%-75%)and 75%-90%recovery time(T75%-90%)of rocuronium were recorded.Peripheral venous blood samples(3 ml)were collected when T1 recovered to 25%and 75%,and the concentration of rocuronium was detected by liquid chromatography-tandem mass spectrum.The consumption of rocuronium per unit of weight per minute was calculated.Results There was no significant difference between the two groups in terms of Tonset,Tpeak,T10%,T10%-25%,T25%-50%,T50%-75%,T75%-90%,endotracheal intubation conditions,blood concentration of rocuronium at varied time points,or consumption of rocuronium per unit of weight per minute(P>0.05).Conclusion Gender exerts no effect on the neuromuscular blockade of rocuronium in epileptics.

关 键 词：性别因素 癫痫 雄甾烷醇类 神经肌肉阻滞 剂量效应关系 药物 

分 类 号：R742[医药卫生—神经病学与精神病学]