罗库溴铵按去脂肪体重与体重给药药效学对比研究.docVIP

中青年优秀论文评选 罗库溴铵按去脂肪体重与体重给药药效学对比研究 南方医科大学珠江医院麻醉科 (510282) 电话:020王鑫 徐世元 刘辉 张庆国 雷洪伊 范凤飞 【摘要】　目的 比较按与按给药临床药效及个体差异全身麻醉择期手术患者例，ASAⅠ～Ⅱ级，按给药量计算方法不同随机分为组（组）和体重组（W组），每组例。静脉注射异丙酚2mg/kg、芬太尼3ug/kg、ROC（2倍ED95，组）或0.6mg/kg（2倍ED95，W组）。以TOF方式监测神经肌肉阻滞（NMB）程度， T1达最低时行气管插管。靶控输注异丙酚3～4ug/ml及间断静脉注射芬太尼维持麻醉。记录麻醉诱导前（T0）、给予肌松药后5min（T1）、15min（T2）、30min（T3）、45min（T4）、1h（T5）时的MAP和HR；记录气管插管条件、起效时间、T1最大抑制程度、临床作用时间、恢复指数、药理作用时间。用SPSS13.0软件包进行处理。计量资料用均数±标准差表示，行方差齐性检验。一般资料、组间的MAP、HR、T1最大抑制、起效时间、临床作用时间、药理作用时间、恢复指数和肌松药用量采用两独立样本t检验。组内的MAP、HR采用重复测量的方差分析。插管条件采用两独立样本非参数检验。性别比采用卡方检验。ROC T1最大抑制、起效时间、临床作用时间、药理作用时间、恢复指数和用量变异度用u检验。P＜0.05有统计学差异。一般情况、血流动力学变化、气管插管条件、肌松效应差异均无统计学意义(P0.05)；P＜0.05)两组间T1最大抑制、起效时间、、变异度均没有显著差异(P0.05)；与组比较，作用时间 (u=,P＜0.05)和(u=2.1273,P＜ 0.05)不同个体间的差异较小。按应用ROC减少其肌松效应及阻滞时效的个体差异，用药量。 Pharmacodynamics comparative of rocuronium administrated according to lean body mass and weight. WANG Xin,Xu Shi-yuan,LUO De-xing, et al. Department of Anesthesiology,Zhujiang Hospital,Southern Medical University,Guangzhou 510282,China. Corresponding author : Xu Shi-yuan (E-mail:xushiyuan355@)【Abstract】　Objective To compara the clinical efficacy and individual differences ofadministered according to lean body mass and body weight. Methods Eighty ASA Ⅰor Ⅱ patients without any neuromuscular disease undergoing elective surgery under general anesthesia were randomly divided into two groups(group W and group L) according to the different administration method of calculating the amount ,40 patients in each group. The responses of adductor pollicis to train of four(TOF) stimulation of ulnar nerve were monitored by HXD-Ⅰmultifunction .Anesthesia was induced with propofol 2mg/kg, fentanyl 3ug/kg, ROC0.6mg/kg (group W) or 0.86mg/kg (group L),and maintained with propofol given by TCI(target-controlled infusion) with the effect-site concentration set at 3 ~ 4ug / ml and increments fentanyl 1ug / kg as required. Before and after anesthesia induction, record systolic blood pressure(SBP), mean pressure (MAP