国际麻醉学与复苏杂志   2016, Issue (5): 7-7
    
癫痫患者罗库溴铵95%有效量的测定
雷洪伊, 张庆国, 张鸿飞, 刘辉, 徐世元1()
1.南方医科大学珠江医院麻醉科
Determination of the 95% effective dose values of rocuronium bromide in epilepsy patients
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摘要:

目的 通过测定癫痫患者罗库溴铵95%有效量(95% effective dose, ED95),为癫痫患者合理应用罗库溴铵提供依据。 方法 选取择期行癫痫病灶切除术患者40例,ASA分级Ⅰ、Ⅱ级。根据罗库溴铵不同剂量按随机数字表法分为4组(每组10例):120 μg/kg组、180 μg/kg组、240 μg/kg组和300 μg/kg组。采用单次剂量注射法测定患者ED95,记录拇指内收肌“四个成串刺激(train of four stimulation, TOF)”第1个肌颤搐反应(T1)最大抑制的百分比及药物的起效时间,将最大抑制百分比进行概率单位转换,罗库溴铵的首次剂量做对数转换, 用直线回归方法建立维库溴铵的剂量?蛳反应曲线,计算出癫痫患者的罗库溴铵ED95值。 结果 各组间一般情况比较,差异无统计学意义(P>0.05);不同剂量组起效时间比较,差异无统计学意义(P>0.05),T1最大抑制程度随剂量增加而增加(P<0.05),但240 μg/kg组和300 μg/kg组间差异无统计学意义(P>0.05);癫痫患者罗库溴铵ED95值为445.3 μg/kg,高于目前正常人群广泛应用的ED95值300 μg/kg(P<0.05)。 结论 癫痫患者罗库溴铵的ED95值高于正常人群,在该类患者中应增加罗库溴铵的剂量约50%以取得与正常人群相同的肌松水平。

关键词: 癫痫; 罗库溴铵; 95%有效量
Abstract:

Objective This study was to determine the values for 95% effective dose(ED95) of rocuronium in epilepsy patients. Methods Fourty epilepsy patients between 18 and 65 years of age, with ASA physical status classicfication Ⅰ or Ⅱ, undergoing elective surgery were enrolled. All patients were randomly divided into four groups(n=10) and were received (120, 180, 240 μg/kg and 300 μg/kg) rocuronium respectively. Neuromuscular monitoring of the ulnar nerve consisted of surface electrode stimulation and force transduction of the adductor pollicis muscle. Neuromuscular block was assessed by the percentages of maximum suppression in T1 of train of four stimulation(TOF). The data of maximum suppression in T1 were transformed into probit and dosage of rocuromium were transformed into logarithm. The onset time of rocuromium was recorded. The dose-effect curve of rocuronium was set up with linear regression method. And the ED95 value of rocuromium was calculated. Results There was not a significant variation in onset time among four groups(P>0.05). The maximum suppression in T1 were increased in group of higher dose(P<0.05), however there was no significant different between group 240 μg/kg and group 300 μg/kg(P>0.05). The ED95 value of rocuromium in epilepsy patients is 445.3 μg/kg, and that was higher than normal people with 300 μg/kg ED95 value(P<0.05). Conclusions The ED95 value of rocuromium in epilepsy patients is higher than non-epilepsy patients. The present data support the larger dose rocuronium is needed in epilepsy patients.

Key words: Epilepsy; Rocuronium; 95% effective dose