性别对维库溴铵气管插管半数有效浓度的影响

The gender difference between Ce_(50) for vecuronium during intubation

目的探讨性别对维库溴胺气管插管半数有效浓度的影响。方法采用序贯实验法测定不同性别患者维库溴铵气管插管的半数有效浓度(Ce50)。ASAⅠ或Ⅱ级全麻手术患者60例,分为男性组(M组)和女性组(W组),每组30例。将效应室靶浓度值(Ce)按等比级数分成4个阶梯,M组为0.29、0.35、0.42和0.50μg/ml,W组为0.20、0.24、0.29和0.35μg/ml。采用序贯实验法肌松药靶控输注(TCI)维库溴铵,计算其诱导插管的Ce50及95﹪CI。结果M组Ce50为0.38μg/ml(95%CI:0.37～0.40μg/ml);W组Ce50为0.27μg/ml(95%CI:0.25～0.29μg/ml),且为M组的71%。W组血浆蛋白水平低于M组(P<0.05)。结论女性患者Ce50小于男性,其原因可能与男女之间血浆蛋白含量等方面的差异有关。

Objective To determine the median effective concentration of vecuronium during intubation in patients with different gender by sequential experimental method. Methods Sixty patients （ASA Ⅰ or Ⅱ ）scheduled for selective surgical procedure under general anesthesia were studied. The patients were divided into two groups, male and female, with 30 cases in each group. The effective local concentration was divided into four grades by geometric progression growth, 0.29, 0.35, 0.42, 0.50 μg/ml in the male group and 0.20, 0.24, 0.29, 0.35μg/ml in the female group. The target controlled infusion of vecuronium was administered by sequential experimental method,and the Ce50 and 95 % confidence interval of vecuronium during intubation in either group were determined using the formula of W. J. Dixon ＆ K.Brownlee. Results Ce50 was 0.38 μg/ml and the 95 % CI was 0.37-0.40 μg/ml in the male group, whereas 0.27 μg/ml and 0.25-0.29 μg/ml in the female group respectively. Ce50 in the female group was 71% of that in the male group. The concentration of plasma total protein and albumin in the female group was lower than that in the male group （P〈0.05）. Conclusions Ce50 is remarkably lower in the female group than that in the male group, which is possibly related to the difference in sex , such as the concentration of plasma total protein and albumin.