摘要
目的：评估内嵌Szenohradszkay参数的罗库溴铵靶控输注（TCI）系统用于不同年龄患者的系统性能。方法：选择ASAI或Ⅱ级全麻手术患者40例，分为中青年组和老年组，各20例，靶控输注罗库溴铵，间断采集动脉血测定罗库溴铵血药浓度。采用偏离度、精确度、摆动度评价TCI系统性能。结果：两组患者罗库溴铵TCI期间，各时点实测浓度均高于靶浓度（P〈0．05）。老年组TCI系统偏离度为14．55％、精确度为28．86％、摆动度为14．82％；中青年组TCI系统偏离度为31．45％、精确度为35．86％、摆动度为20．52％。结论：Szenohradszkay参数用于老年患者靶控输注罗库溴铵，偏离度、精确度符合系统性能要求，用于中青年组，偏离度和精确度均大于TCI系统性能要求的范围，需要进一步优化。
Objective To evaluate the performance of target-controUed infusion system for rocuronium using pharmacokinetic parameter reported by Szenohradszkay to predict plasma rocuronium concentration in different age patients. Methods 40 patients （ASA grade Ⅰ or Ⅱ ） scheduled for selective surgical procedure under general anaesthesia were studied. The patients were divided into two groups, young group and older group ,containing 20 cases each. The target-controlled infusion of rocuronium using pharmacokinetic parameter reported by Szenohradszkay was administered, and arterial blood samples were taken before induction of anesthesia （T0 baseline）, at 2, 5, 10, 20, 30, 40rain after start of TCI （T1-6） for determination of blood rocuronium concentrations.Comparing measured with target concentrations the median performance error （MDPE）, mean absolute performance error （MDAPE） and wobble were calculated. ResuRs Compared with target concentrations, the measured concentrations were all higher during TCI in two groups. The difference between the target and measured concentrations was significant during T1-6 （ P 〈 0. 05）. During 40 min of TCI of rocuronium MDPE, MDAPE and wobble were 14.55%, 28.86%, 14.82% respectively in the older group,which were 31.45%, 35.86%, 20.52% respectively in the young group. Conclusion The pharmacokinetic parameter reported by Szenohradszkay is suitable for the eldly, but unsuitable for the young. Futher study on the population pharmacokinetics of young men is needed.
