不同年龄对顺式阿曲库铵肌松效应的影响

目的观察不同年龄对顺式阿曲库铵肌松效应的影响。方法选择择期小儿或成人手术共90例，ASAⅠ～Ⅱ级，年龄1个月～59岁。按年龄分成3组：成人组（Ⅰ组）30例（16—59岁），儿童组（11组）30例（2～12岁），幼儿组（Ⅲ组）30例（1个月～2岁）；每组按首次给予顺式阿曲库铵的量（30、4｜D、50μg·kg-1）再分成3个亚组，一共9组。采用咪达唑仑-丙泊酚-芬太尼进行麻醉诱导和维持，每例患者先随机给予一个首次剂量（30、40、50μg·kg-1）后，观察TOF刺激反应，当同等程度T1反应连续重复3次时，记录T1抑制程度，计算量一效关系曲线和ED95，再给每个患者静注顺式阿曲库铵使总量达到100μg·kg-1。对T1达100％抑制的患者观察顺式阿曲库铵的恢复时相。结果所有患者在抑制达到100％时完成气管插管，插管条件达到1级有83例（92．2％），达到2级有7例（7．8％）；成人组、儿童组和幼儿组的ED95分别为59．29、55．88、45．39μg·kg-1,3组患者E风值与年龄的增加呈正相关。成人组与儿童组比较，临床肌松维持时间、临床肌松有效作用时间、体内肌松作用时间较长（P〈0．05），而与幼儿组比较，其以上3个作用时间较短（P〈0．05），但3组间恢复指数无明显差异（P〉0．05）。结论年龄对顺式阿曲库铵的肌松效应有一定影响。

Research of different ages on muscle relaxation effect of cisatracurium

AIM To observe the influences of different ages on muscle relaxation effect of cisatraeurium. METHODS Ninty patients, ASA grade Ⅰ -Ⅱ , aged 1 month - 59 years, scheduled for elective surgery were included in the study. All patients were divided into 3 groups according to their ages：group Ⅰ , 30 patients aged 16 - 59 years; group Ⅱ , 30 patients aged 2- 12 years; group Ⅲ ,30 patients aged 1 month - 2 years. And the patients of each group were divided into 3 subgroups by first dose given. General anesthesia was induced and maintained with midazolam, propofoI and fentanyl. Every patient was given a first dose （ 30,40,50μg·kg-1） randomly, and the stimulating response of train-of-four （TOF） stimulation was observed. When the same degree of the first response （ T1 ） continuously repeating three times, the percentage depression of degree of T1, and compute the curve of dose-effect relations and ED95 were recorded. Then every patient was given eisatraeurium amount to 100μg· kg- 1. When T1 reached the maximum block effect （ 100% ）, recovery phase were observed. RESULTS When maximum block effect was 100%, the intubation was completed. Grade one was 83 patients （92.2%）,and grade two was 7 patients （7.8%）.The values of ED95 of all patients were positive con＇elated with the increase of age. The value of ED95 of group Ⅰ , group Ⅱ and group m were 59.29,55.88 and 45.39 μg·kg- 1, respectively. There were significant differences of clinical duration and total duration of action between the 3 age of groups （ P 〈 0.05 ）, but there were no significant differences of the recovery index between the 3 age of groups （ P 〉 0.05 ）. CONCLUSION Age could significandy affect the music relaxation effect of cisatraeurium.