罗库溴铵两种不同给药方式肌松效果的比较

Comparison of Muscle Relaxant Effects between Two Administrations of Rocuronium

目的 比较罗库溴铵（ROC）体表面积给药法与体重给药法麻醉诱导时ROC的用药剂量、肌松起效时间、肌松恢复时间、气管插管时的肌松效果及插管时血压、心率的变化.方法 全身麻醉择期手术患者40例,ASA Ⅰ-Ⅱ级,麻醉诱导时采用单次剂量法给予ROC,根据ROC给药方法不同随机分为体表面积组（A组）和体重组（B组）,每组20例.A组ROC用量为ROC体表面积ED95的3倍（ROC体表面积的ED95=8.32mg/m^2）,B组ROC用量为ROC体重的ED95的3倍（ROC体重的ED95 =0.3 mg/kg）.记录A、B2组ROC的用量、肌松起效时间、肌松恢复时间、气管插管时收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）、心率（HR）、气管插管时患者的Cooper评分.结果 肌松起效时间、Cooper气管插管评分及插管时SBP、DBP、MAP、HR 2组差异无统计学意义（P＞0.05）,A组ROC用量低于B组（P＜0.05）,肌松恢复时间A组较B组快（P＜0.05）.结论 采用体表面积法给予罗库溴铵,可减少罗库溴铵的用量,同时能达到与体重法给药法相同的起效时间和肌松效果,肌松恢复较体重法快,对于时间较短的手术,更为安全合理.

Objective To compare the dosages of rocuronium （ROC）,the onset time of muscle relaxation,the recovery time of muscle relaxation,the effect of muscle relaxation during tracheal intubation and the changes of blood pressure,heart rate when intubating between the medication of surface area and the weight medication of ROC during induction of anesthesia.Methods 40 patients underwent general anesthesia operation,ASA Ⅰ - lⅡ.Single dose administration of ROC was used during induction of anesthesia.According to the different administrative methods of ROC,these patients were randomly divided into two groups,surface area group （group A） and weight group （B group）,20 patients in each group.ROC dosage of group A was 3 times of the ED95 of the surface area of ROC （the ED95 of the surface area of ROC =8.32 mg/m^2） ROC dosage of group B was 3 times of the ED95 of the weight of ROC （the ED95 of the weight of ROC=0.3 mg/kg）.We respectively recorded the A group＇s and B group＇s ROC dosage,neuromuscular onset time,recovery time of muscle relaxation and systolic blood pressure （SBP）,diastolic blood pressure （DBP）,mean arterial pressure （MAP）,heart rate （HR）,Cooper score of patients during tracheal intubation.Results The onset time of muscle relaxation,Cooper score of tracheal intubation and SBP,DBP,MAP,HR during intubation of the two groups had no significant differences,the dosage of ROC in group A was lower than that of group B （P〈0.05）.The recovery time of muscle relaxation in group A was faster than in group B.Conclusions Given rocuronium with the method of body surface area can reduce the dosage of rocuronium and also can achieve the same onset time and the effect of muscle relaxation comparing with the method of weight,the recovery time of muscle relaxation is faster.It is more reasonable and safe for shorter time operation.