CAJ | 학술논문

目的比较维库溴铵按体表面积与按体重给药用于全麻患者的药效学.方法择期全麻手术患者40例,ASA分级Ⅰ或Ⅱ级,年龄18～64岁,体重40～ 85 kg,采用随机数字表法,将其随机分为2组(n=20):按2倍体重ED95给药组(W组)和按2倍体表面积ED95给药组(S组).麻醉诱导:静脉注射异丙酚2 mg/kg和芬太尼3μg/kg,W组和S组分别静脉注射维库溴铵0.1 mg/kg和2.824mg/m2.T1达最大抑制时行气管插管,机械通气,维持呼气末二氧化碳分压35～45 mm Hg.术中维持BIS值40～50.采用Cooper评分法评估气管插管条件.记录肌松起效时间、T1最大抑制程度、临床作用时间、恢复指数、药理作用时间和维库溴铵用量,计算各指标的变异系数.结果两组气管插管条件、起效时间、临床作用时间、恢复指数和药理作用时间的变异系数比较差异无统计学意义(P＞0.05).与W组比较,S组T1最大抑制程度和维库溴铵用量的变异系数减小(P＜0.05).结论按2倍体表面积ED95给予维库溴铵可减少全麻患者药效学的个体差异.
목적 비교유고추안안체표면적여안체중급약용우전마환자적약효학.방법 택기전마수술환자40례,ASA분급Ⅰ혹Ⅱ급,년령18～64세,체중40～ 85 kg,채용수궤수자표법,장기수궤분위2조(n=20):안2배체중ED95급약조(W조)화안2배체표면적ED95급약조(S조).마취유도:정맥주사이병분2 mg/kg화분태니3μg/kg,W조화S조분별정맥주사유고추안0.1 mg/kg화2.824mg/m2.T1체최대억제시행기관삽관,궤계통기,유지호기말이양화탄분압35～45 mm Hg.술중유지BIS치40～50.채용Cooper평분법평고기관삽관조건.기록기송기효시간、T1최대억제정도、림상작용시간、회복지수、약리작용시간화유고추안용량,계산각지표적변이계수.결과 량조기관삽관조건、기효시간、림상작용시간、회복지수화약리작용시간적변이계수비교차이무통계학의의(P＞0.05).여W조비교,S조T1최대억제정도화유고추안용량적변이계수감소(P＜0.05).결론 안2배체표면적ED95급여유고추안가감소전마환자약효학적개체차이.
Objective To compare pharmacodynamics of vecuronium administered according to body surface area and body weight during general anesthesia.Methods Forty ASA Ⅰ or Ⅱ patients,aged 18-64 yr,weighing 40-85 kg,undergoing general anesthesia,were randomly divided into 2 group ( n =20 each ).The patients received vecuronium 2× ED95 based on body weight (group W) or based on body surface area (group S).Anesthesia was induced with propofol 2 mg/kg,fentanyl 3 μg/kg and vecuronium 0.1 mg/kg ( group W) or 2.824 mg/m2 (group S).The patients was tracheal intubated and mechanically ventilated when the maximal depression of T1 was achieved.PET CO2 was maintained at 35-45 mm Hg and BIS value was maintained at 40-50.The intubation condition was evaluated using Cooper's score.The onset time,maximal depression of T1,duration of clinical action,recovery index,duration of pharmacological action and amount of vecuronium consumed were recorded.The coefficient of variation for all the indexes mentioned above was calculated.Results There was no significant difference in the coefficient of variation for intubation condition,onset time,duration of clinical action,recovery index,and duration of pharmacological action between the two groups ( P ＞ 0.05).Compared with group W,the coefficient of variation for the maximal depression of T1 and amount of vecuronium consumed were significantly decreased in group S ( P ＜ 0.05).Conclusion Vecuronium 2 × ED95 administered according to body surface area can reduce the individual variation in pharmacodynamics during general anesthesia.