年龄对顺式阿曲库铵靶控输注药效学的影响

目的探讨靶控输注(TCI)顺式阿曲库铵时年龄对其药效学的影响。方法接受丙泊酚-N2O/O2-芬太尼复合麻醉的患者40例均分为Ⅰ组(62～85岁)和Ⅱ组(20～59岁)。在四个成串刺激(TOF)监测下静注顺式阿曲库铵0.15mg/kg。待TOF的T1为0时行气管插管,并对插管条件进行评级。待T1恢复至5%时开始TCI阿曲库铵,保持T1<10%。记录神经肌肉阻滞的起效时间、无反应期、阻滞维持时间和停药后肌松恢复时间,并记录顺式阿曲库铵的用药量。结果两组起效时间及恢复指数差异无统计学意义;Ⅰ组无反应期、阻滞维持时间和停药后肌松恢复时间明显长于Ⅱ组(P<0.05);顺式阿曲库铵的平均用药量明显少于Ⅱ组(P<0.05)。结论老年患者TCI顺式阿曲库铵用药量虽然相应减少,但其恢复过程仍较青壮年延长。

Effect of age on pharmacodynamics of cisatracurium target-controlled infusion

Objective To evaluate the effect of age on pharmacodynamics of eisatracurium target-controlled infusion(TCI). Methods Forty patients under N_2O-O_2-propofol-fentanyl anesthesia were divided into groups of Ⅰ and Ⅱ with 20 cases each. Under TOF stimulation monitoring, eisatracurium 0. 15 mg/kg was injected and tracheal intubation was performed when TOFr being zero. and the intubation conditions were evaluated. When T1 restored to 50% cisatracurium TCI started to keep TOFr less than 10%. The recovery times of neuromuscular blockade were recorded after stopping infusion. The amount of cisatracurium consumption was calculated. Results Intubation conditions the onset time and recovery index were not significantly different between two groups. The nonresponse period, duration of action, and recovery time were longer in group Ⅰ than those in group B. Cisatracurium consumption was more in group Ⅰ than that in group Ⅱ (P<0.05). Conclusion By TCI,cisatracurium dosage needed for keeping TOFr less than 10% is less,but the recovery process is still longer in the elderly than those in the younger.