| 李 岩,白福海,李慧明,王洁茹,路志红.米库氯铵闭环靶控输注用于全麻老年患者的药效学研究[J].,2018,(9):1683-1686 |
| 米库氯铵闭环靶控输注用于全麻老年患者的药效学研究 |
| Closed-looped Target-controlled Infusion of Mivacurium for the Elderly Patients Undergoing General Anesthesia |
| 投稿时间：2017-12-07 修订日期：2018-01-10 |
| DOI：10.13241/j.cnki.pmb.2018.09.017 |
| 中文关键词: 米库氯铵 老年患者 闭环靶控输注 |
| 英文关键词: Mivacurium Elderly patients Closed-looped target-controlled infusion |
| 基金项目:国家自然科学基金项目（81473488） |
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| 中文摘要: |
| 摘要 目的：探讨米库氯铵用于老年患者闭环输注的用量及其药效学。方法：选择择期全麻手术青年(18~30岁)和老年患者(60~75岁)各35例，经闭环肌松注射系统给予米库氯铵，采用4个成串刺激尺神经，通过拇内收肌的收缩反应以监测TOF值(T4/T1)。记录两组患者注入米库氯铵后的肌松起效时间、血流动力学变化、不良反应及停药后的神经肌肉功能的恢复情况。结果：两组患者在诱导期T1至T4各时间点HR、SBP、DBP、SpO2的比较，差异均无统计学意义(P>0.05)。与青年组相比，老年组米库氯铵闭环输注肌松起效时间和恢复时间均较长(P<0.05)，但拔管时间无差别(P>0.05)。米库氯铵闭环输注肌松抑制THD>90 %的用量老年组为3.6±1.7 μg?kg-1?min-1，青年组为4.3±1.5 μg?kg-1?min-1，差异无统计学意义(P>0.05)。两组患者均未发现皮肤潮红、支气管痉挛、低血压、肌松残余等不良反应。结论：米库氯铵闭环输注应用于老年患者术毕拔管时间与青年患者相当，且不增加不良反应，是老年患者肌松诱导和维持的可选方案。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the pharmacodynamics of mivacurium by closed-looped target-controlled infusion in the elderly patients. Methods: 35 cases of patients aged 18~30 and 35 cases of patients aged 60~75 years scheduled for elective surgery under general anesthesia were enrolled. Patients received closed-loop infusion of mivacurium for neuromuscular blockade. The extent of mus- cular relaxant was assessed by acceleromyography in adductor pollicis. The onset time (time from drug administration to maximum ef- fects), hemodynamics index, time to TOF>90 %, time to extubation and adverse effects during recovery were recorded. Results: There was no significant difference in the HR, SBP, DBP and SpO2 between the two groups during the induction period from T1 to T4(P>0.05). The time to maximal blockade and to the recovery of TOF>90 % of the younger patients were shorter than those of the elderly patients (P<0.05). No significance was found in the time to extubation between the two groups. The mean mivacurium requirements by closed-looped infusion for maintenance of 90 % block was 3.55±1.66 μg?kg-1?min-1 in elderly patients, and 4.32±1.48 μg?kg-1?min-1 in younger patients(P>0.05). There was no evidence of skin erythema, bronchospasm, hypotension, muscle relaxants and other adverse reac- tions during the surgery in either group. Conclusion: Time to extubation and adverse effects were comparable in elderly patients and younger patients when mivacurium was given byclosed-looped infusion. Closed-looped infusion of mivacurium could be an option for the elderly patients. |
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