CAJ | 학술논문

背景肥胖患者麻醉药药代与药效动力学较体重正常人群个体差异更大,其心输出量与身体肌肉、脂肪等组织构成比的变化影响众多麻醉药物分布、消除规律,按总体重给药易致药物过量,按理想体重给药则可能剂量不足. 目的阐述常用静脉麻醉药在肥胖患者中的药代与药效动力学特性,有助于此类患者合理用药,减少并发症. 内容综述肥胖患者常用静脉麻醉药按总体重、理想体重、体表面积和瘦体重用药研究现状. 趋势为避免肥胖患者肌松药术后残余作用所致并发症,非去极化肌松药按理想体重给药较合适,而大多数静脉麻醉药(包括阿片类药物)则适于按瘦体重给药.
배경 비반환자마취약약대여약효동역학교체중정상인군개체차이경대,기심수출량여신체기육、지방등조직구성비적변화영향음다마취약물분포、소제규률,안총체중급약역치약물과량,안이상체중급약칙가능제량불족. 목적 천술상용정맥마취약재비반환자중적약대여약효동역학특성,유조우차류환자합리용약,감소병발증. 내용 종술비반환자상용정맥마취약안총체중、이상체중、체표면적화수체중용약연구현상. 추세 위피면비반환자기송약술후잔여작용소치병발증,비거겁화기송약안이상체중급약교합괄,이대다수정맥마취약(포괄아편류약물)칙괄우안수체중급약.
Background Obese patients have greater inter-individual variations than the standard-size patients in the anesthetic pharmacokinetics and pharmacodynamics.In obese population,changes in cardiac output and alterations in body composition affect the distribution of numerous anaesthetics,therefore,administration of drugs based on total body weight could result in overdose,conversely,administration of drugs based on ideal body weight could result in an inadequate dose.Objective This review focuses on the pharmacokinetics and pharmacodynamics properties of intravenous anesthetic in obese patients in order to provide recommendation for rational application of intravenous anesthetic in obese patients and reduce complications.Content Discussing dosing scalars based on total body weight,ideal body weight,body surface area and lean body weight as well as its recent advances in clinical application of intravenous anaesthetics in the obese.Trend To avoid postoperative residual curarization,the ideal body weight might be appropriate for dosing scalar of the non-depolarizing neuromuscular blocking agents,whereas,lean body weight is the optimal dosing scalar for the majority of anaesthetic agents including opioids and anaesthetic-induction agents for obese patients.