【摘要】 目的 采用单次剂量注射法建立癫痫患者顺式阿曲库铵的剂量反应曲线，确定其量效关系及ED95，为癫痫患者合理应用顺式阿曲库铵提供依据。方法 选取择期癫痫手术患者40例，ASA Ⅰ～ Ⅱ级，年龄16～42岁, 病史3～26 年，均具有服用抗癫痫药物史，术前无酸碱平衡及水电解质紊乱，心肺、肝肾功能正常。患者随机分为20μg/kg组、30μg/kg组、40μg/kg组、50μg/kg组共四个剂量组，每组10例。记录拇内收肌四个成串刺激反应中第一次反应最大抑制的百分率，并进行概率单位转换，将顺式阿曲库铵的首次剂量进行对数转换, 用直线回归方法建立顺式阿曲库铵的剂量-反应曲线，并记录起效时间。结果 癫痫患者顺式阿曲库铵ED50、ED75、ED90、ED95值分别为36.3μg/kg、46.1μg/kg、57.4μg/kg、65.4μg/kg，起效时间在四个剂量组之间差异无显著性(P > 0.05)。结论 本研究测得癫痫患者顺式阿曲库铵ED95值为65.4μg/kg，比目前临床采用的正常人ED9550μg/kg增加30.8%。
[Abstract] Objective To determine the dose-response curve of Cisatracurium and to evaluate the ED95 of Cisatracurium in epilepsy patients. Methods Forty ASA grade Ⅰor Ⅱ epilepsy patients were enrolled in this study .All patient were divided into four groups and were determined with the method of single dose injection under midazolam-fentanyl intravenous anesthesia.Each of four groups of patients received intravenous bolus of 20、30、40、50 μg/kg of Cisatracurium respectively.The neuromuscular block was measured by Neuromuscular Transmission Monitor，the responses were defined in terms of the percentages of maximum suppression in T1 of TOF of the adductor pollicis muscle. According to log-probit transformation of the data of dose and response, the dose-response curve of Cisatracurium was established through linear regression. The onset time of Cisatracurium was also observed.Results The ED50、ED75、ED90 and ED95 of Cisatracurium in epilepsy patients were 36.3μg/kg、46.1μg/kg、57.4μg/kg、65.4μg/kg.No significant change in onset time among 4 groups. Conclusion The ED95 of Cisatracurium in epilepsy patients is 65.4μg/kg, increasing of 30.8% than the ED95 50μg/kg of normal human.
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