不同麻醉诱导剂量顺阿曲库铵在老年肿瘤患者中的应用  

Clinical application of different induction doses cisatracurium in elderly cancer patients

作　　者：张雪 刘溪 吴启超[1] 吴歆[1] 孙志荣[1] ZHANG Xue;LIU Xi;WU Qi-chao;WU Xin;SUN Zhi-rong(Fudan University Shanghai Cancer Center/Department of Oncology,Fudan University Shanghai Medical College,SHANGHAI 200032,China)

机构地区：[1]复旦大学附属肿瘤医院/复旦大学上海医学院肿瘤学系,上海200032

出　　处：《中国新药与临床杂志》2020年第5期290-293,共4页Chinese Journal of New Drugs and Clinical Remedies

基　　金：上海市科学技术委员会科研计划项目(16DZ1911107,16DZ1930304)。

摘　　要：目的观察不同麻醉诱导剂量顺阿曲库铵在老年肿瘤患者中应用的肌松时效及不良反应。方法选择拟于全麻下行择期腹部肿瘤切除术的患者120例,按年龄分为老年组(年龄≥65岁,A组)和非老年组(18岁<年龄<65岁,N组),各组再随机分为顺阿曲库铵2倍95%有效剂量(ED95)组(A2、N2)、3倍ED95组(A3、N3)和4倍ED95组(A4、N4),每组20例,诱导时分别单次静脉注射顺阿曲库铵0.10、0.15、0.20 mg·kg-1,其他麻醉方法相同。记录肌松药起效时间、临床作用时间、恢复时间,给药前后患者血流动力学变化及不良反应发生情况。结果老年和非老年患者相同剂量顺阿曲库铵组间比较,肌松起效时间、临床作用时间和恢复时间均无显著差异(P> 0.05)。与A2组相比,A3组诱导剂量维持时间延长(P <0.05),A4组肌松起效时间缩短、诱导剂量维持时间延长,差异均有显著意义(P <0.05)。各组心率、平均动脉压均在正常范围内,组间比较均无显著差异(P> 0.05),均无皮肤潮红、支气管痉挛、低氧血症、上呼吸道梗阻、气促等不良反应发生。结论不同诱导剂量顺阿曲库铵可在老年肿瘤患者中安全使用,高诱导剂量可缩短肌松起效时间,但延长作用时间。AIM To observe the efficacy and adverse reactions of cisatracurium with different anesthesia induction doses in elderly cancer patients. METHODS One hundred and twenty patients undergoing elective abdominal tumor resection under general anesthesia were selected and divided into two groups according to age: aged group(group A, ≥ 65 years old) and non-aged group(group N, > 18 years old and < 65 years old). Then each group was randomly divided into cisatracurium 2 ED95 group(A2, N2), 3 ED95 group(A3, N3) and 4 ED95 group(A4, N4), 20 cases in each group. Single intravenous injection of cisatracurium 0.10, 0.15 and 0.20 mg·kg-1 was given respectively during induction, and other anesthesia methods were the same. The onset time, clinical effect time, recovery index, hemodynamic changes before and after administration of cisatracurium and adverse reactions were recorded. RESULTS There was no significant difference in the onset time, clinical effect time and recovery time of muscle relaxant between the same dose of cisatracurium in different age groups(P > 0.05). Compared with group A2, group A3 with longer induction dose maintenance time(P < 0.05), and group A4 with longer induction dose maintenance time but shorter onset time(P < 0.05). The heart rate and mean arterial pressure of each group were within the normal range, and there was no significant difference between the groups(P > 0.05). No adverse reactions such as skin flushing, bronchospasm, hypoxemia, upper respiratory obstruction and shortness of breath were found in all groups. CONCLUSION Cisatracurium with different induction doses can be safely used in elderly cancer patients. High induction doses can shorten the onset time of muscle relaxation, but prolong the action time.

关 键 词：老年人 肿瘤 顺阿曲库铵 剂量效应关系 药物 安全 

分 类 号：R971[医药卫生—药品]