摘要
目的 探讨不同的给药方式和性别对顺式阿曲库铵药效学的影响.方法 选择60例ASA I^II级择期手术的患者,根据性别和给药方式分成4组（每组15例）：女性靶控输注（TCI）组、女性间断单次静脉注射组、男性TCI组以及男性间断单次静脉注射组.用TOF-Watch肌松监测仪以间隔12s连续监测4个成串刺激尺神经后拇内收肌的收缩反应.并记录顺式阿曲库铵插管剂量和单位时间用量、肌松起效时间 （从开始给药到T1/TC达5%的时间）以及肌松自主恢复时间（最后一次给药或者停止输注T1/TC 恢复到75%的时间）.结果 TCI时顺式阿曲库铵插管剂量（0.11±0.04）mg/kg小于间断单次静注（0.15±0.00）mg/kg,P＜0.01;单位时间的用药剂量也小于单次注射（P＜0.01）;但起效时间显著延长（P＜0.01）.TCI时自主恢复时间明显缩短（P＜0.01）.与男性相比,女性患者的肌松需要量显著减少,而肌松起效时间缩短,但肌松恢复时间不受影响.结论 TCI时顺式阿曲库铵的用量少,肌松恢复快.女性患者对顺式阿曲库铵比男性敏感,起效快.表明女性患者肌松需要减小剂量.
Objective To investigate the effect of different administration method and gender of patients on phamocodynamics of cisatracurium Methods Sixty ASA grade Ⅰ-Ⅱ patients without any neuromuscular diseases underwent elective surgery under total intravenous anesthesia, 30 patients （15 females and 15 males） received cisatracurium by target controlled in- fusion （TCI）, while the other 30 patients （15 females and 15 males） received cisatracurium by intermittent bolus injection. Neuromuscular block following cisatracurium was monitored by T＆F-Watch monitor with train-of-four （TOF） stimulations on ulnar nerve at 12-s interval. The onset time （from administration of cisatracurium to T1/Tc of 5%）, the spontaneous recovery time （from last bolus dose or completion of intravenous injection of cisatracurium to spontaneous recovery to T1/Tc of 75%）, the intubating doses of cisatracurium and doses per minute of cisatracurium were recorded, Results Compared to intermittent bolus injection, the dosages of intubation cisatracurium were significantly lower in TCI mode [（0.11 ± 0.04）mg/kg vs （0.15 ± 0.00）mg/kg, P〈0.01]; dosages per minute of cisatracurium in TCI mode were also lower （P〈0.01）; the spontaneous recovery time was shorter（P〈0.01）, while onset time was longer （P〈0.01）. The significant gender differences in phamacodynamics of cisatracurium were observed, the dose requirements of cisatracurium were lower in women compared to men. The onset time was shorter in females than that in males, while the spontaneous recovery time was identical for both genders. Conclusion Cisatracurium administered by TCI mode is superior to intermittent bolus injection. Females are more sensitive to cisatracurium than males, suggesting that the routine dose of cisatracurium should be reduced in female patients.
出处
《浙江医学》
CAS
2012年第12期1006-1008,共3页
Zhejiang Medical Journal
基金
浙江省医学会临床科研基金（2011ZYC-A88）
