老年肥胖病人顺式阿曲库铵按去脂体质量给药对其95%有效剂量的影响

The effect of cisatracurium administered according to fat-free body mass on 95%effective dose in elderly obese patients

目的观察老年肥胖病人顺式阿曲库铵按去脂体质量(FFM)给药对其95%有效剂量(ED_(95))的影响。方法选择2020年9月20日至2021年9月30日在秦皇岛市第一医院择期行全麻手术老年(年龄≥65岁)肥胖病人40例。根据随机数字表法分为OF1~OF4组,每组10例(男女各5例),采用单次剂量法按FFM分别给予40、50、60、70μg/kg的顺式阿曲库铵,给药后使用Mindray BeneVision N17型监护仪进行肌松监测,记录拇内收肌第1个肌颤搐反应(T1)最大抑制值及起效时间,对顺式阿曲库铵单次剂量进行对数转换,将T1最大抑制值进行概率单位转换,用直线回归方法建立量效曲线,计算其ED_(95)。结果T1最大抑制值随剂量的增加而增大(P<0.05),得出ED_(95)为70.5μg/kg。结论老年肥胖病人按FFM给予顺式阿曲库铵的ED_(95)为70.5μg/kg。

Objective To evaluate the effect of cisatracurium administered according to fat-free body mass(FFM)on 95%effective dose in elderly obese patients.Methods A total of 40 elderly obese patients(age≥65)were selected to undergo elective general anesthesia surgery at the First Hospital of Qinhuangdao City from September 20,2020,to September 30,2021.Utilizing the random number table method,participants were allocated into four groups(OF1 to OF4),with ten patients in each group(five males and five females).A single-dose administration of cis-atracurium was tailored according to fat-free mass(FFM),with respective doses of 40,50,60,and 70μg/kg.Following drug administration,muscle relaxation was monitored using the Mindray BeneVision N17 monitor;we recorded both the maximum inhibition value of the medial digit flexor muscle(T1)and the onset time.The single-dose cis-atracurium data were logarithmically transformed while T1 maximum inhibition values underwent probability unit conversion.A linear regression analysis was employed to establish a dose-response curve from which ED_(95) was calculated.Results The maximum inhibitory value of T1 exhibited a significant increase with the dose escalation(P<0.05).The ED_(95) was determined to be 70.5μg/kg.Conclusion The ED_(95) values of cisatracurium in aged obesity patients,administered based on FFM,were determined to be 70.5μg/kg.