吲哚氰绿排泄试验评价肝储备功能与罗库溴铵药效学的关系

目的 研究肝脏储备功能与罗库溴铵药效学的关系.方法 71 例肝硬化失代偿患者择期行分流加断流术,于术前1d行吲哚氰绿(ICG)排泄试验.按15 min ICG储留率(ICGR_15)将患者分为I_1,组、I_2与I_3组,另20例肝功能正常患者为对照组(C组).静脉麻醉诱导后静脉注射罗库溴铵0.6mg/kg,当T_1恢复至对照值的25%时第二次静脉注射罗库溴铵1/2首次剂量.持续临测拇内收肌群颤搐高度,观察静脉麻醉下罗库溴铵起效时间、T1最大抑制程度、首次诱导剂量的临床作用时间、术毕自主恢复指数.同时监测重复追加维持剂量的临床作用时间及各组的平均用药量.结果 I_2组与I_3组肌松起效时间、TOF恢复时间、恢复指数均明显长于C组和I_1组(P<0.05或P<0.01),I_3组尤反应期明显长于C组、I_1组及I_2组(P<0.01).重复追加罗库溴铵4次以上,临床作用时间具有I_3组>I_2组>I_1组的规律.平均用药量I_3组

Relationship between hepatic potential capacity and the pharmcodynamics of rocuronium

Objective To investigate the relationship between hepatic potential capacity and the pharmcodynarnics of rocuroniurn.Methods The indocyanine green (ICG) excretion test waspertormed one day before operation in 71 patients with decompensated hepatic cirrhosis scheduled to receive devascularization combined with splenectomy.On the basis of ICG retention at 15 min(ICGR_(15)),the patients were divided into groups of I_1(22 cases,ICGR_(15)≤10),I_2(35 cases,1020).Another 20 healthy people(group C)were taken as thecontrols.Rocuronium 0.6 mg/kg was intravenously infused and 0.3 mg/kg rocuronium、was addedwhen T_1 value recovered to 25%control value.The twitch high of adductor pollicis muscle wasrecorded.The time of onset,T1 maximum depression,the clinical duration of initial dose,and thespontanous recovery index were recorded.The clinical duration of repeated maintenance doses and themean dosage of each group were recorded as well.Results The onset time,25% TOF responsePeriod and the recovery index after operation were significantly prolonged in groups of I_2 and I_3compared with those in groups of C and I_1(P<0.05 or P<0.01).No response period of grouP I_3was longer than that of other three groups(P<0.0 1).When the maintenance dose of rocuronium wasadded for more than four times,the clinical action time also showed to be prolonged in an older of I_3>I_2＞I_1 and mean dose reduced in an order of I_3