CAJ | 학술논문

目的采用单次剂量注射法建立癫痫患者顺式阿曲库铵的剂量反应曲线,确定其量效关系及ED95,为癫痫患者合理应用顺式阿曲库铵提供依据.方法选取择期癫痫手术患者40例,ASA Ⅰ～Ⅱ级,年龄16岁～42岁,病史3年～26年,均具有服用抗癫痫药物史,术前无酸碱平衡及水电解质紊乱,心肺、肝肾功能正常.患者按随机数字法分为20μg/kg组、30μg/kg组、40 μg/kg组、50μg/kg组共4个剂量组,每组10例.记录拇内收肌四个成串刺激反应中第1次反应最大抑制的百分率,并进行概率单位转换,将顺式阿曲库铵的首次剂量进行对数转换,用直线回归方法建立顺式阿曲库铵的剂量-反应曲线,并记录起效时间.结果癫痫患者顺式阿曲库铵ED50、ED75、ED90、ED95值分别为36.3、46.1、57.4、65.4μg/kg,起效时间在4个剂量组之间差异无统计学意义(P＞0.05).结论本研究测得癫痫患者顺式阿曲库铵ED95值为65.4 μg/kg,比目前临床采用的正常人ED9550μg/kg增加30.8%.
목적 채용단차제량주사법건립전간환자순식아곡고안적제량반응곡선,학정기량효관계급ED95,위전간환자합리응용순식아곡고안제공의거.방법 선취택기전간수술환자40례,ASA Ⅰ～Ⅱ급,년령16세～42세,병사3년～26년,균구유복용항전간약물사,술전무산감평형급수전해질문란,심폐、간신공능정상.환자안수궤수자법분위20μg/kg조、30μg/kg조、40 μg/kg조、50μg/kg조공4개제량조,매조10례.기록무내수기사개성천자격반응중제1차반응최대억제적백분솔,병진행개솔단위전환,장순식아곡고안적수차제량진행대수전환,용직선회귀방법건립순식아곡고안적제량-반응곡선,병기록기효시간.결과 전간환자순식아곡고안ED50、ED75、ED90、ED95치분별위36.3、46.1、57.4、65.4μg/kg,기효시간재4개제량조지간차이무통계학의의(P＞0.05).결론 본연구측득전간환자순식아곡고안ED95치위65.4 μg/kg,비목전림상채용적정상인ED9550μg/kg증가30.8%.
Objective To determine the dose-response curve and the ED95 of cisatracurium in epilepsy patients. Methods Forty ASA grade Ⅰ or Ⅱ epilepsy patients were randomly divided into four groups. The dose-response curve was determined by single bolus injection of cisatracurium under midazolam-fentanyl intravenous anesthesia. For each group, the dose of cisatracurium were 20,30, 40 and 50 μg/kg respectively. The neuromuscular block was measured by Neuromuscular Transmission Monitor, and the responses were defined in terms of the percentages of maximum suppression in T1 of TOF of the adductor pollicis muscle. After logprobit transformation of the data of dose and response, the dose-response curve of cisatracurium was then established by linear regression. The onset time of cisatracurium was also recorded. Results The ED50, ED75, ED90 and ED95 of cisatracurium in epilepsy patients were 36.3, 46.1, 57.4 and 65.4 μg/kg. There was no significant change in onset time among 4 groups. Conclusion The ED95 of cisatracurium in epilepsy patients is 65.4 μg/kg, which is about 30.8% higher than that in normal human.