CAJ | 학술논문

目的：比较罗库溴铵（ROC）按体表面积与实际体重间断静注给药的药效学特点及个体化差异，为临床如何合理应用ROC提供参考。方法：择期全麻手术患者42例，ASAⅠ～Ⅱ级，随机分成BSA 组和RBW组，每组21例。采用TOF-Watch SX肌松监测仪以TOF 刺激方式刺激尺神经，监测拇内收肌的收缩反应。全麻诱导分别按体表面积和实际体重静注2倍ED95 ROC （BSA 组按16．64 mg/m2计算，RBW组按0．6 mg/kg计算），当T1恢复至10％时，重复间断静注0．5倍ED95剂量，预计手术结束前30 min 停止追加ROC。记录肌松维持及恢复过程，并记录 ROC 的用量。结果：两组肌松阻滞时效各指标差异无统计学意义（P＞0．05）。 BSA组ROC单次追加药量及维持用药量均显著小于RBW组（P＜0．05）。与RBW组相比，BSA组在单次追加药量、加药间隔时间、药理作用时间、TOFr恢复至0．7的时间个体间变异度更小（P＜0．05）。结论：ROC按体表面积间断静注给药可获得与按实际体重给药相似的肌松效应，减少肌松药用量，亦可减少肌松阻滞时效的个体差异。
목적：비교라고추안（ROC）안체표면적여실제체중간단정주급약적약효학특점급개체화차이，위림상여하합리응용ROC제공삼고。방법：택기전마수술환자42례，ASAⅠ～Ⅱ급，수궤분성BSA 조화RBW조，매조21례。채용TOF-Watch SX기송감측의이TOF 자격방식자격척신경，감측무내수기적수축반응。전마유도분별안체표면적화실제체중정주2배ED95 ROC （BSA 조안16．64 mg/m2계산，RBW조안0．6 mg/kg계산），당T1회복지10％시，중복간단정주0．5배ED95제량，예계수술결속전30 min 정지추가ROC。기록기송유지급회복과정，병기록 ROC 적용량。결과：량조기송조체시효각지표차이무통계학의의（P＞0．05）。 BSA조ROC단차추가약량급유지용약량균현저소우RBW조（P＜0．05）。여RBW조상비，BSA조재단차추가약량、가약간격시간、약리작용시간、TOFr회복지0．7적시간개체간변이도경소（P＜0．05）。결론：ROC안체표면적간단정주급약가획득여안실제체중급약상사적기송효응，감소기송약용량，역가감소기송조체시효적개체차이。
Objective To compare the pharmacodynamics of rocuronium intermittently administered according to body surface area and real body weight and individual differences. Method Forty-two patients undergoing elective surgery under general anesthesia were enrolled into the body surface area group (BSA group) and the real body weight group (RBW group), with 21 patients in each group. The patients in the two groups were induced with 2ED95 of rocuronium according to body surface area and real body weight (16.64 mg/m2 in BSA group; 0.6 mg/kg in RBW group). Whenever T1 recovered to 10%, a dosage of 0.5ED95 was administred repeatedly for 30 min before the end of the operation. The time of neuromuscular blockade and recovery of muscle relaxation were recorded, and the dosage of rocuronium was also recorded. Results No significant difference in each index of neuromuscular block time-effect was found between the two groups (P > 0.05). The single dosage and maintainance amount of muscle relaxation were less in the BSA group than that in RBW group (P < 0.05). Compared with the RBW group, the single dosage, dosing intervals, pharmacological duration and the time TOFr recovered to 0.7 between the different individuals were less in the BSA group (P < 0.05). Conclusion The intermittent administration of rocuronium can maintain the same clinical efficacy according to body surface area as that according to real body weight , with significantly less dosageand reducing the differences of individuals in blockade time-effect of muscle relaxation.