年龄对女性患者罗库溴铵气管插管半数有效剂量的影响

Effect of age on ED_(50) of rocuronium for intratracheal intubation in female patients

目的通过序贯实验法测定不同年龄女性患者罗库溴铵气管插管的半数有效剂量(IED50),并探讨年龄因素对罗库溴铵IED50的影响。方法选择ASAⅠ～Ⅱ级,择期全麻手术女性患者40例,分为中青年组和老年组,每组20例。将气管插管剂量按等比级数分成4个阶梯,中青年组为0.24、0.29、0.35和0.42mg/kg,老年组为0.22、0.26、0.31和0.37mg/kg。按照序贯实验方法单次静注罗库溴铵,并计算罗库溴铵气管插管的IED50和95%可信区间(95%CI)。结果中青年组IED50为0.312mg/kg,老年组IED50为0.284mg/kg,老年组的IED50是中青年组的91%(P<0.05)。结论老年女性患者气管插管罗库溴铵IED50显著低于中青年女性患者,使用罗库溴铵麻醉诱导时,应适当减少剂量。

Objective To determine the half-effective dose （IEDso） ofrocuronium for intratracheal intubation in female patients of different ages by sequential experiments and evaluate the effect of age on IED50 of rocuronium. Methods Forty ASA class Ⅰ-Ⅱ female patients undergoing elective surgery under general anesthesia were randomly divided （n=20） into young patient group and elderly patient group. The intratracheal intubation dose was divided into 4 grades by geometric progression, namely 0.24, 0.29, 0.35, and 0.42 mg/kg in the young patient group and 0.22, 0.26, 0.31, and 0.37 mg/kg in the elderly group. The IEDs0 and 95% confidence interval （95%CI） ofrocuronium during intubation in both groups were determined by sequential experiments. Results The IEDso was 0.284 mg/kg in the elderly patient group, which was 91% that of in the young patient group （0.312 mg/kg）, showing significant difference between the two groups （P〈0.05）. Conclusion The IED50ofrocuronium is significantly lower in elderly female patients than in young female patients, suggesting the necessity of reducing the dose of rocuronium accordingly in anesthesia induction in elderly female patients.