中国医药
中國醫藥
중국의약
CHINA MEDICINE
2013年
z1期
54-56
,共3页
药效学%顺式阿曲库铵%老年%全凭静脉麻醉
藥效學%順式阿麯庫銨%老年%全憑靜脈痳醉
약효학%순식아곡고안%노년%전빙정맥마취
Pharmacodynamics%Cisatracurium%Elderly%Intravenous anesthesia
目的 探讨在全凭静脉麻醉中年龄对顺式阿曲库铵药效学的影响.方法 随机选择于全身麻醉下行腰椎内固定择期手术患者40例,跟据年龄随机分为Ⅰ组(62～81岁)和Ⅱ组(41 ～59岁),麻醉诱导后单次静脉注射顺式阿曲库铵0.15 mg/kg(3倍ED95),用TOF Watch SX加速度仪进行肌松监测,待TOF的T1为0时行气管插管,2组患者肌松T1恢复5％时,单次注射顺式阿曲库铵(5s内注完)0.05 mg/kg,共注射4次(不足4次补足4次,多于4次取前4次),观察气管插管条件及顺式阿曲库铵的药效学.结果 2组患者起效时间及恢复指数比较,差异无统计学意义.Ⅰ组临床有效作用时间、停药后肌松恢复至25％和75％的时间分别为(42±5)、(52±7)、(66±13) min,Ⅱ组分别为(40±5)、(49±5)、(62±11) min,Ⅰ组明显长于Ⅱ组(P＜0.05).Ⅰ组和Ⅱ组术中4次追加顺式阿曲库铵的临床有效作用时间组内比较,差异无统计学意义；组间比较,Ⅰ组明显长于Ⅱ组(P＜0.05).Ⅰ组顺式阿曲库铵单位时间用药量(3.5±1.3) μ.g/(min·kg),明显少于Ⅱ组的(4.6±1.5)μg/(min · kg) (P ＜0.05).结论 老年患者在全凭静脉麻醉中顺式阿曲库铵用药量虽相应减少,恢复过程仍较轻壮年延长,但长期反复追加用药在体内几乎无蓄积作用,可以安全应用.
目的 探討在全憑靜脈痳醉中年齡對順式阿麯庫銨藥效學的影響.方法 隨機選擇于全身痳醉下行腰椎內固定擇期手術患者40例,跟據年齡隨機分為Ⅰ組(62～81歲)和Ⅱ組(41 ～59歲),痳醉誘導後單次靜脈註射順式阿麯庫銨0.15 mg/kg(3倍ED95),用TOF Watch SX加速度儀進行肌鬆鑑測,待TOF的T1為0時行氣管插管,2組患者肌鬆T1恢複5％時,單次註射順式阿麯庫銨(5s內註完)0.05 mg/kg,共註射4次(不足4次補足4次,多于4次取前4次),觀察氣管插管條件及順式阿麯庫銨的藥效學.結果 2組患者起效時間及恢複指數比較,差異無統計學意義.Ⅰ組臨床有效作用時間、停藥後肌鬆恢複至25％和75％的時間分彆為(42±5)、(52±7)、(66±13) min,Ⅱ組分彆為(40±5)、(49±5)、(62±11) min,Ⅰ組明顯長于Ⅱ組(P＜0.05).Ⅰ組和Ⅱ組術中4次追加順式阿麯庫銨的臨床有效作用時間組內比較,差異無統計學意義；組間比較,Ⅰ組明顯長于Ⅱ組(P＜0.05).Ⅰ組順式阿麯庫銨單位時間用藥量(3.5±1.3) μ.g/(min·kg),明顯少于Ⅱ組的(4.6±1.5)μg/(min · kg) (P ＜0.05).結論 老年患者在全憑靜脈痳醉中順式阿麯庫銨用藥量雖相應減少,恢複過程仍較輕壯年延長,但長期反複追加用藥在體內幾乎無蓄積作用,可以安全應用.
목적 탐토재전빙정맥마취중년령대순식아곡고안약효학적영향.방법 수궤선택우전신마취하행요추내고정택기수술환자40례,근거년령수궤분위Ⅰ조(62～81세)화Ⅱ조(41 ～59세),마취유도후단차정맥주사순식아곡고안0.15 mg/kg(3배ED95),용TOF Watch SX가속도의진행기송감측,대TOF적T1위0시행기관삽관,2조환자기송T1회복5％시,단차주사순식아곡고안(5s내주완)0.05 mg/kg,공주사4차(불족4차보족4차,다우4차취전4차),관찰기관삽관조건급순식아곡고안적약효학.결과 2조환자기효시간급회복지수비교,차이무통계학의의.Ⅰ조림상유효작용시간、정약후기송회복지25％화75％적시간분별위(42±5)、(52±7)、(66±13) min,Ⅱ조분별위(40±5)、(49±5)、(62±11) min,Ⅰ조명현장우Ⅱ조(P＜0.05).Ⅰ조화Ⅱ조술중4차추가순식아곡고안적림상유효작용시간조내비교,차이무통계학의의；조간비교,Ⅰ조명현장우Ⅱ조(P＜0.05).Ⅰ조순식아곡고안단위시간용약량(3.5±1.3) μ.g/(min·kg),명현소우Ⅱ조적(4.6±1.5)μg/(min · kg) (P ＜0.05).결론 노년환자재전빙정맥마취중순식아곡고안용약량수상응감소,회복과정잉교경장년연장,단장기반복추가용약재체내궤호무축적작용,가이안전응용.
Objective To evaluate the effect of age on pharmacodynamics of cisatracurium in total intravenous anesthesia.Methods Foay patients with lumbar vertebra internal fixation surgery under total intravenous anesthesia were divided into group Ⅰ and Ⅱ with 20 cases in each group.Under TOF stimulation monitoring,cisatracurium 0.15 mg/kg was infected and tracheal intubation was performed when TOF being zero.When T1 restored to 5％,cisatracurium 0.05 mg/kg(injected within 5 s each time) was injected at irregular intervals.The intubation conditions and the pharmacodynamcs of cisatracurium were evaluated.Results Intubation conditions of the onset time and recovery index were not significantly different between the two groups.The clinical effective time and recovery to 25％ and 75％ time was(42 ±5),(52 ±7),(66 ± 13)min,and group]Ⅱ was(40 ±5),(49 ±5),(62 ± 11) min,the group Ⅰ was longer than group Ⅱ.Each clinical effective time of the four times additional drugs in group Ⅰ was longer than that in group Ⅱ.There was no notable difference on that between the two groups.Cisatracurium average dosage was less in group Ⅰ [(3.5 ± 1.3) μg/(min · kg)] than that in group Ⅱ [(4.6 ± 1.5) μg/(min · kg)] (P ＜ 0.05).Conclusion In TIVA in elderly patients the cisatracurium dosage reduces,recovery process is still longer compared to young adults,but long-term repeated additional medication almost leave no accumulation in the body,which can be safely applied.
