摘要
目的 研究顺阿屈库铵在国人中的临床药效过程。方法 选择年龄 30～ 6 5岁择期全麻手术病人 10 0例。静脉诱导用异丙酚 2mg/kg、芬太尼 4μg/kg。各项循环监测指标稳定 5min后 ,研究分两部分进行。第一部分 :将病人随机分成七组 ,每组 10例 ,Ⅰ组 2 5 μg/kg、Ⅱ组 30 μg/kg、Ⅲ组35 μg/kg、Ⅳ组 40 μg/kg、Ⅴ组 45 μg/kg、Ⅵ组 5 0 μg/kg、Ⅶ组 5 5 μg/kg。测定各组顺阿屈库铵的作用强度 ,计算ED50 和ED95值。第二部分 :根据顺阿屈库铵诱导用量将病人分为两组 ,每组 15例 ,Ⅷ组 2倍ED95,Ⅸ组 3倍ED95。当T1达到最大抑制时行气管插管。记录拇收肌诱发颤搐反应的抑制时程和恢复过程 ,分析给药后血压和心率的波动及两组插管效果。结果 顺阿屈库铵的ED50 值为 30 7μg/kg ,ED95值为 5 3 4μg/kg ,2倍和 3倍ED95的起效时间分别为 2 5 4 3± 83 5s和 190 0± 5 9 4s ,临床作用时间为 38 8± 6 1min和 5 3 2± 8 8min ,恢复指数为 (16 4± 4 9)min和 (15 6± 5 2 )min。Ⅷ组和Ⅸ组给予顺阿屈库铵后血压和心率无明显变化 ,两组插管评级无显著差异 (P >0 0 5 )。结论 顺阿屈库铵国人ED50 值为 30 7μg/kg ,ED95值为 5 3 4μg/kg。 3倍ED95比 2倍ED95起效快 ,维持时间长。全麻诱导时用 3倍ED95?
Objective This study was designed to determine the clinical pharmacokinetics of cisatracurium in Chinese patients.The purpose of this study was twofold: the determination of ED 50 and ED 95 of cisatracurium and the intubating conditions and changes in BP and HR produced by 2×ED 95 and 3×ED 95.Methods 100 patients scheduled for elective surgery, aged 30-65 years, served as the experimental subjects.Anesthesia was induced with propofol 2mg/kg and fentanyl 4μg/kg.5 min after BP and HR were stabilized the study was started.The study consisted of two parts according to the purpose of the study.In part Ⅰ 70 patients were included and randomized to 7 groups based on the doses of cisatracurium the patients received.The doses were 25,30,35,40,45,50 and 55 μg/kg from group Ⅰ to Ⅶ.Neuromuscular transmission was assessed by measuring the responses of adductor pollicis muscle to stimulation of ulnar nerve with TOF pulses. The maximal depression of T 1 was measured after administration of cisrtracurium, and ED 50 and ED 95 were calculated.In part Ⅱ 30 patients were included and divided into two groups to receive 2×ED 95 (group Ⅷ) or 3×ED 95 (group Ⅸ) of cisatracurium.The intubating conditions were evaluated.The onset time and time of recovery from paralysis as well as the changes in BP and HR after administration of cisatracurium were recorded.Results ED 50 and ED 95 for cisatracurium were 30.7μg/kg and 53.4μg/kg respectively.The onset times for 2×ED 95 and 3×ED 95 were (254±84)s and (190±59)s.The durations of action was (38.8±6.1)min and (53.2±8.8)min respectively.Recovery indexes were (16.4±4.9)min and (15.6±5.2)min.There were little changes in BP and HR after administration of cisatracurium in both group Ⅷ and Ⅸ.The intubating conditions were not significantly different.Conclusions ED 50 and ED 95 for cisatracurium are 30.7μg/kg and 53.4μg/kg in Chinese patients.The onset time is shorter and duration of action longer with 3×ED 95 which does notsignificantly affect BP and HR.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2001年第1期10-13,共4页
Chinese Journal of Anesthesiology
