术前急性高容量血液稀释对罗库溴铵量效关系及作用时间的影响  

Effect of preoperative acute hypervolaemic haemodilution on the dose-effect relationship and time-course of action of rocuronium

作　　者：胡俊峰 罗婷[2] 吴安石[2] Hu Junfeng;Luo Ting;Wu Anshi(Department of Anesthesiology,Beijing Chaoyang-Huairou Hospital,Capital Medical University,Beijing 101400,China)

机构地区：[1]首都医科大学附属北京朝阳医院怀柔医院麻醉科 [2]首都医科大学附属北京朝阳医院麻醉科

出　　处：《北京医学》2024年第1期38-42,共5页Beijing Medical Journal

摘　　要：目的 探讨术前急性高容量血液稀释(acute hypervolaemic haemodilution,AHH)对罗库溴铵量效关系及作用时间的影响。方法 选取2022年4—10月首都医科大学附属北京朝阳医院怀柔医院需择期进行全麻手术的患者80例,随机分成AHH组和对照组,每组40例。AHH组麻醉30 min内静脉输注15 ml/kg 6%羟乙基淀粉,对照组30 min内缓慢滴注1~2 ml/kg 6%羟乙基淀粉。比较两组患者的一般情况,AHH前(t1)、AHH完成即刻(t2)、4个成串刺激(train of four,TOF)=0.9即刻(t3)的血液及尿液相关指标,罗库溴铵的绝对作用时间[自T1(第1个颤搐反应)=0至T1=1%所需时间]、临床作用时间(自T1=0至T1=25%所需时间)、体内作用时间(自T1=0至TOF=0.9所需时间)和恢复指数(T1从25%恢复至75%所需时间)。结果 80例患者中男50例、女30例;平均年龄(53.2±4.6)岁;平均身高(167.41±6.35)cm;平均体质量(67.88±6.38)kg。与t1相比,AHH组t2和t3的Hb、红细胞压积、TP、ALB、K^(+)、Mg^(2+)、Ca^(2+)、HR均降低;与对照组t2和t3相比,AHH组同时段的Hb、红细胞压积、TP、ALB、K^(+)、Ca^(2+)、Mg^(2+)、HR均较低,MAP和尿量均较高;差异均有统计学意义(P<0.05)。AHH组和对照组罗库溴铵的量效关系方程分别为y=105.7lgX-172.7和y=104.9lgX-169.0。两组罗库溴铵的ED_(50)、ED_(90)、ED_(95)、绝对作用时间、临床作用时间、体内作用时间和恢复指数方面的差异均无统计学意义(P> 0.05)。结论 15 ml/kg 6%羟乙基淀粉进行AHH不明显改变罗库溴铵的量效关系及作用时间。Objective To explore the effect of preoperative acute hypervolaemic haemodilution(AHH) on the doseeffect relationship and time-course of rocuronium.Methods A total of 80 patients requiring elective surgery under general anesthesia admitted to Beijing Chaoyang-Huairou Hospital affiliated to Capital Medical University from April to October 2022 were selected,and were randomly divided into AHH group and control group,with 40 patients in each group.The AHH group was infused intravenously 15 ml/kg of 6% hydroxyethyl starch within 30 min after anesthesia,while the control group instilled 1~2 ml/kg of 6% hydroxyethyl starch slowly within 30 min after anesthesia.The general conditions,the blood and urine related indicators at the time of before AHH(t1),immediately after AHH completion(t2),immediately after train of four(TOF) = 0.9(t3),the absolute time-course of action [time ranged from T1(the first twitch response) = 0 to T1 = 1%],clinical time-course of action(time ranged from T1 = 0 to T1 = 25%),in vivo time-course of action(time ranged from T1 = 0 to TOF = 0.9) and recovery index(time ranged from T1 25% to 75%) were compared between the two groups.Results Among the 80 patients,there were 50 males and 30 females.The average age was(53.2 ± 4.6) years,the average height was(167.41 ± 6.35) cm,and the average body weight was(67.88 ± 6.38) kg.Compared with t1,the levels of Hb,hematocrit,TP,ALB,K~+,Mg~(2+),Ca~(2+) and HR were decreased in AHH group at t2 and t3 periods.Compared with the control group at t2 and t3,the levels of Hb,hematocrit,TP,ALB,K~+,Ca~(2+),Mg~(2+) and HR in AHH group were decreased,while the levels of MAP and urine volume were higher,the differences were statistically significant(all P < 0.05).The dose-effect relationship equations of rocuronium in AHH group and control group were y = 105.7lgX-172.7 and y = 104.9lgX-169.0,respectively.There were no significant differences in ED_(50),ED_(90),ED_(95),absolute time-course of action,clinical time-course of action,in vivo time-course of action and recovery

关 键 词：急性高容量血液稀释 罗库溴铵 量效关系 作用时间 

分 类 号：R614[医药卫生—麻醉学]