中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2009年
3期
203-206
,共4页
雄甾烷醇类%剂量效应关系,药物%年龄因素%儿童
雄甾烷醇類%劑量效應關繫,藥物%年齡因素%兒童
웅치완순류%제량효응관계,약물%년령인소%인동
Andrestanoh%Dose-response relationship,drug%Age factors%Child
目的 比较新生儿、婴儿、幼儿和儿童罗库溴铵的药效学.方法 择期全麻手术患儿160例,ASAⅠ或Ⅱ级,根据年龄分为4组(n=40):新生儿组、婴儿组、幼儿组及儿童组.各组随机选取患儿20例,采用4次累积给药法静脉注射罗库溴铵,初始剂量:新生儿组40 μg/kg,婴儿组80 μg/kg,幼儿组及儿童组均为120 μg/kg,后3次均追加罗库溴铵40μg/kg.每次给药后.观察TOF反应.当T1连续3次稳定不变时,给予下一次剂量.采用概率单位法计算T1抑制50%、90%、95%的用药量(ED50、ED90、ED95).各组随机选取20例患儿,静脉注射2倍ED95剂量的罗库溴铵,记录肌松起效时间、高峰时间、临床肌松时间、体内作用时间和恢复指数.结果 与新生儿组比较,幼儿组和儿童组罗库溴铵ED50、ED90和ED95均升高(P<0.01),婴儿组上述指标差异无统计学意义(P>0.05).婴儿组、幼儿组和儿童组罗库溴铵起效时间、临床肌松时间和体内作用时间缩短,恢复指数降低(P<0.01);与幼儿组比较.儿童组罗库溴铵ED50、ED90和ED95升高(P<0.01).结论 不同年龄患儿对罗库溴铵的量效关系和时效关系存在明显的差别,新生儿对罗库溴铵的敏感性最强.
目的 比較新生兒、嬰兒、幼兒和兒童囉庫溴銨的藥效學.方法 擇期全痳手術患兒160例,ASAⅠ或Ⅱ級,根據年齡分為4組(n=40):新生兒組、嬰兒組、幼兒組及兒童組.各組隨機選取患兒20例,採用4次纍積給藥法靜脈註射囉庫溴銨,初始劑量:新生兒組40 μg/kg,嬰兒組80 μg/kg,幼兒組及兒童組均為120 μg/kg,後3次均追加囉庫溴銨40μg/kg.每次給藥後.觀察TOF反應.噹T1連續3次穩定不變時,給予下一次劑量.採用概率單位法計算T1抑製50%、90%、95%的用藥量(ED50、ED90、ED95).各組隨機選取20例患兒,靜脈註射2倍ED95劑量的囉庫溴銨,記錄肌鬆起效時間、高峰時間、臨床肌鬆時間、體內作用時間和恢複指數.結果 與新生兒組比較,幼兒組和兒童組囉庫溴銨ED50、ED90和ED95均升高(P<0.01),嬰兒組上述指標差異無統計學意義(P>0.05).嬰兒組、幼兒組和兒童組囉庫溴銨起效時間、臨床肌鬆時間和體內作用時間縮短,恢複指數降低(P<0.01);與幼兒組比較.兒童組囉庫溴銨ED50、ED90和ED95升高(P<0.01).結論 不同年齡患兒對囉庫溴銨的量效關繫和時效關繫存在明顯的差彆,新生兒對囉庫溴銨的敏感性最彊.
목적 비교신생인、영인、유인화인동라고추안적약효학.방법 택기전마수술환인160례,ASAⅠ혹Ⅱ급,근거년령분위4조(n=40):신생인조、영인조、유인조급인동조.각조수궤선취환인20례,채용4차루적급약법정맥주사라고추안,초시제량:신생인조40 μg/kg,영인조80 μg/kg,유인조급인동조균위120 μg/kg,후3차균추가라고추안40μg/kg.매차급약후.관찰TOF반응.당T1련속3차은정불변시,급여하일차제량.채용개솔단위법계산T1억제50%、90%、95%적용약량(ED50、ED90、ED95).각조수궤선취20례환인,정맥주사2배ED95제량적라고추안,기록기송기효시간、고봉시간、림상기송시간、체내작용시간화회복지수.결과 여신생인조비교,유인조화인동조라고추안ED50、ED90화ED95균승고(P<0.01),영인조상술지표차이무통계학의의(P>0.05).영인조、유인조화인동조라고추안기효시간、림상기송시간화체내작용시간축단,회복지수강저(P<0.01);여유인조비교.인동조라고추안ED50、ED90화ED95승고(P<0.01).결론 불동년령환인대라고추안적량효관계화시효관계존재명현적차별,신생인대라고추안적민감성최강.
Objective To compare pharmacodynamics of rocuronium in neonates,infants,young children and children.Methods One hundred and sixty ASA Ⅰ or Ⅱ pediatric patients undergoing elective surgical procedures under total intravenous anesthesia(TIVA)were divided into 4 groups according to ages(n=40 each):neonate group(0-28d),infant group(28 d<age 12 months),young children group(1 yr<age≤3 yr)and children group(3 yr<age≤10 yr).Twenty patients Were randomly selected from each group,and rocuronium was administered iv by using cumulative dose-response technique at four doses(an initial dose of 40 μg/kg, 80 μg/kg,120μg/kg and 120μg/kg in neonate,infant,young children and children groups respectively,and three increments of 40μg/kg each).After each administration,TOF response was observed.When T1 was stable, the next administration was given.50%,90%and 95%effective dose(ED50,ED90.ED95)were calculated by Probite method.Twenty patients were randomly selected in each group were given rocuronium 2 times of ED95.The onset time,duration of peak effect.clinical duration.total duration and recovery index were recorded.Results ED50,ED90 and ED95 of rocuronium were significantly higher in young children and children groups than in neonate group(P<0.01),but there there was significant difference in the indices mentioned above between infant and neonate group(P>0.05).Onset time of muscle relaxation.clinical duration and total duration were significantly shorter and recovery index lower in the other 3 groups than in neonate group(P<0.01).but there was no significant difference in the duration of peak effect among the 4 groups(P>0.05).ED50,ED90 and ED95 of rocuronium were significantly higher in children group than in young children group(P<0.01).Conclusions There are significant differences in dose-effect and time-effect relationships among different age children and neonate is more sensitive to rocuronium than the other age children.
