年龄对顺式阿曲库铵肌松效应的影响

Influence of age on neuromuscular block effect of cisatracurium

目的观察并比较单次静脉注射2倍95%的有效药物剂量(ED95)顺式阿曲库铵对不同年龄患者的肌松效应。方法将60例按美国麻醉协会(ASA)标准定为Ⅰ～Ⅱ级的患者分为幼儿组(3～7岁)、青壮年组(18～65岁)和老年组(≥65岁),每组20例。麻醉诱导期间单次注入2倍ED95顺式阿曲库铵,用TOF Watch加速度仪进行肌肉松弛监测,观察起效时间、阻滞维持时间、临床作用时间、体内作用时间和恢复指数。结果 3组间气管插管评级差异无统计学意义(P>0.05)。幼儿组肌松起效时间、阻滞维持时间、临床作用时间及体内作用时间均明显短于青壮年组和老年组,差异有统计学意义(P<0.05)。3组的肌松恢复指数比较差异无统计学意义(P>0.05)。结论幼儿对顺式阿曲库铵更为敏感,起效快,肌松阻滞维持时间和作用时间短,与成人的肌松效应相似;肌松恢复时间与年龄无关,2倍ED95诱导剂量对不同年龄的患者均安全有效。

Objective To investigate the neuromuscular block effect of intravenous injection of two times of 95% effective dose（ED95） of cisatracurium in patients with different ages. Methods Sixty patients with ASA Ⅰ-Ⅱ were divided into children group（3 to 7 years old）,youth group（18 to 65 years old） and elder group（≥ 65 years old）,with 20 patients in each group.Cisatracurium of two times of ED95 was injected during anesthesia induction,neuromuscular block was monitored with TOF Watch acceleration instrument,and the time of neuromuscular block onset,duration of blockade maintenance,duration of clinical action,duration of in vivo action and neuromuscular block recovery index were obtained. ResultsThere was no significant difference in trachea intubation grading among three groups（P0.05）.The time of neuromuscular block onset,duration of blockade maintenance,duration of clinical action and duration of in vivo action in children group were significantly shorter than those in youth group and elder group（P0.05）.There was no significant difference in neuromuscular block recovery index among three groups（P0.05）. Conclusion Children are more sensitive than adults to cisatracurium,with faster neuromuscular block onset,shorter duration of blockade maintenance and shorter duration of clinical action.The neuromuscular block recovery time is not related to age,and two times of ED95 of cisatracurium is safe and effective for patients with different ages.