罗库溴铵靶控输注系统在不同性别患者中的性能评价

Evaluation of performance of target-controlled infusion system for rocuronium bromide in different sex patients

目的评估内嵌Szenohradszkay参数的罗库溴铵靶控输注(TCI)系统用于不同性别患者的系统性能。方法择期全身麻醉(全麻)手术患者40例,ASAⅠ或Ⅱ级,分为男性组和女性组,每组20例。使用Szenohradszkay参数,TCI罗库溴铵,分别于2、5、10、20、30、40 min采集动脉血,应用液相色谱-质谱法(LC-MS)测定罗库溴铵血药浓度。采用偏离度、精确度、摆动度评价2组TCI系统准确性,并进行靶浓度与实测浓度的比较及2组间实测浓度的比较。结果 TCI期间2组的实测浓度均高于靶浓度,其差异有显著意义(P<0.05)。实测浓度的组间比较无显著差异(P>0.05)。40 min内男性组TCI系统的偏离度为28.65%、精确度为30.25%、摆动度为17.22%;女性组TCI系统的偏离度为30.25%、精确度为32.76%、摆动度为19.52%。结论 Szenohradszkay参数用于不同性别患者TCI罗库溴铵,系统偏离度和精确度均大于TCI系统性能要求的范围,性别因素对TCI系统性能无明显影响。

AIM To evaluate the performance of target-controlled infusion（TCI）system for rocuronium bromide using pharmacokinetic parameter reported by Szenohradszkay to predict plasma rocuronium bromide concentration in different sex patients.METHODS Forty patients（ASA ⅠorⅡ）scheduled for selective surgical procedure under general anaesthesia were enrolled.The patients were divided into man group and woman group containing 20 each.Rocuronium bromide was administrated via the TCI system using pharmacokinetic parameter according to Szenohradszky,and arterial blood samples were taken at 2,5,10,20,30,40 min after start of TCI（T1-6）for determination of blood rocuronium bromide concentrations by liquid chromatography-mass spectrometry（LC-MS）.The target concentrations and measured concentrations,and the measured concen-trations between two groups were compared.The median performance error（MDPE）,mean absolute performance error（MDAPE）,and wobble were calculated for evaluation of the accuracy.RESULTS Comparing with target concentrations,the measured concentrations were all higher during TCI in two groups,with significant difference（P 0.05）.There were not significant difference of measured concentrations between two groups（P 0.05）.During 40 min of TCI,the MDPE,MDAPE,and wobble were 28.65%,30.25%,and 17.22% in the man group respectively,which were 30.25%,32.76%,and 19.52% in the woman group respectively.CONCLUSION The pharmacokinetic parameters reported by Szenohradszkay are unsuitable for man or woman patients due to systemic and accuracy deviation greater than those expected of TCI,but the influence of patients sex on TCI of rocuronium bromide is indistinguishable.