年龄和性别对阿曲库铵量—效关系和恢复时相的影响

目的：研究年龄和性别对阿曲库铵量－效关系和恢复时相特征的影响。方法：选择72例（男38例,女34例）ASA I级,年龄15－59岁,施择期整形外科手术的患者,按年龄分成3组：I组,15－29岁（n=32);II组,30－40岁（n=21),III组;41－59岁（n=19),采用60％NO2－O2－硫喷妥钠－芬太尼维持麻醉,用加速度仪监测神经肌肉功能,以累计给药方法建立阿曲库铵的量－效关系曲线,结果：与年龄较大患者和女性患者相比,年轻患者和男性患者阿曲库铵的量－效关系曲线平行左移,用多元直线回归分析发现,年龄和性别与阿曲库铵的量－效关系密切相关,阿曲库铵的ED50,ED90,ED95和应用同等剂量后的临床肌松时间以及体内作用时间在3个年龄组和男,女患者之间差异均有显著性。结论：年龄和性别对阿曲库铵的药效学具有明显影响。

Influences of age and gender on dose-response and recovery time-course of atracurium

OBJECTIVES: To evaluate the influences of age and sex on dose-response and recovery time course of atracurium. METHODS: Seventy-two patients (38 men and 34 women), ASA grade I, aged 15-59 years, scheduled for elective surgery were included in the study. All patients were divided into three groups according to their ages: Group 1, 32 patients aged 15-29 years; Group 2, 21 patients aged 30-40 years, and Group 3, 19 patients aged 41-59 years. General anesthesia was maintained with 60% nitrous oxide in oxygen, thiopentone and fentanyl. Neuromuscular function was assessed by train-of-four(TOF) stimulation of accelerometry and the percentage depression of the first response (T1) of the TOF stimulus was used as the study parameter. The dose-response relations of atracurium were determined by the cumulative dose-response technique. RESULTS: As compared to older and female patients, dose-response curves of atracurium in young and male patients were shifted in a parallel fashion to the left. The dose-response relation of atracurium correlated closely with patients' ages and sexes by multiple linear regression analysis. There were significant differences of ED50, ED90 and ED95, and clinical duration and total duration of action following administration of atracurium of same doses between the three age groups as well as men and women. CONCLUSIONS: Age and gender could significantly affect the pharmacodynamics of atracurium.