顺式阿曲库铵用于不同性别患者的药效学研究

Pharmacodynamics of Cisatracurium in Patients of Different Gender

目的:研究性别差异对顺式阿曲库铵肌松效应的影响。方法:将拟在气管插管全身麻醉下行择期手术的患者28例,分为男性组、女性组,每组14例。血浆靶控输注丙泊酚3μg·mL^(-1)、瑞芬太尼3～6 ng·mL^(-1)、静脉注射顺式阿曲库铵0.15 mg·kg^(-1)行麻醉诱导,以单次颤搐刺激监测神经肌肉阻滞深度,待T_1达最低值行气管插管,并转换为四个成串刺激(TOF),血浆靶控输注丙泊酚3μg·mL^(-1)、瑞芬太尼3～6 ng·mL^(-1)维持麻醉。记录顺式阿曲库铵的肌松作用指标。结果:与女性组比较,男性组身高、体质量较大(P<0.05),但体质量指数差异无统计学意义(P>0.05);起效时间、T_1最大阻滞程度、最大阻滞持续时间、T_1 25%恢复时间、恢复指数差异均无统计学意义(P>0.05)。结论:单次静脉注射顺式阿曲库铵后肌松效应无性别差异。

OBJECTIVE： To study the cisatracurium- induced neuromuscular blockade effect in patients of different gender. METHODS： Twenty eight patients undergoing surgery under tracheal - intubated general anesthesia were assigned to male group（n = 14） and famale group（n=14） . Anesthesia was induced with 3μg·mL^-1 Propofol and 3-6 ng·mL^-1 Remifentanil by target controlled infusion （TCI） and cisatracurium 0.15 mg·mL^-1 i.v. The depth of neuromuscular blockade was monitored by recording the response of adductor pollicis to a single stimulation. The patients were intubated when the depth of neuromuscular blockade （T1） reached minimum, and then a train-of-four （TOF） stimulation was initiated. Anes- thesia was maintained by TCI of 3μg·mL^-1 propofol and 3-6 ng·mL^-1 Remifentanil. The response of adductor pollicis to TOF stimulation was recorded. RESULTS： The body weight and height were significantly higher in male group than in female group （P〈0.05）, but no differences were noted between the two groups in either body mass index （P 〉0.05） or the time to onset, maximal T1 blockade degree, maximal blockade duration, the time needed for T1 returned to 25% and the recovery index （P 〉 0.05）. CONCLUSION： Neuromuscular blockade induced by single i.v. of Cisatracurium showed no gender difference.