文章摘要
肥胖对女性患者罗库溴铵剂量-效应曲线的影响
Effects of obesity on dose response curve of rocuronium in female patients
  
DOI：
中文关键词: 肥胖  肌松监测  罗库溴铵  剂量-效应曲线
英文关键词: Obesity  Neuromuscular monitor  Rocuronium  Dose-response curve
基金项目:中华医学会临床医学科研专项基金-默沙东肌松研究项目（13081410526）
作者单位
王士朝 050000 石家庄市，河北医科大学第二医院麻醉科 
黄立宁 050000 石家庄市，河北医科大学第二医院麻醉科 
康荣田 050000 石家庄市，河北医科大学第二医院麻醉科 
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中文摘要:
      目的 观察肥胖对女性患者罗库溴铵剂量-效应曲线的影响,并计算肥胖女性患者罗库溴铵的95%有效剂量（ED95）。方法 选择择期行全身麻醉女性患者80例,年龄18～45岁,ASA Ⅰ或Ⅱ级,手术时间<1.5 h。根据BMI 20～25 kg/m2和30～35 kg/m2分为N组与B组,每组40例。两组患者根据随机数字表法各分为0.075、0.1、0.15、0.3 mg／kg四个剂量组,分别为N1～N4组和B1～B4组。麻醉诱导同时开启注射泵,待患者意识消失后,校对肌松监护仪,启动TOF模式,N1～N4组和B1～B4组分别给予罗库溴铵单次剂量0.075、0.1、0.15、0.3 mg/kg。记录各组患者给予罗库溴铵的首次剂量、第一个肌颤搐反应（T1）的最大抑制程度和肌松药起效时间。采用直线回归法建立罗库溴铵量效关系回归方程,计算N组和B组患者的ED50和ED95及其95%CI。结果 N组和B组的量效关系回归方程分别为Y1=3.464X1-2.230和Y2=3.843X2-2.750。B组ED50、ED75、ED90、和ED95分别为0.103、0.145、0.201和0.251 mg/kg明显小于N组0.122、0.176、0.254和0.324 mg/kg（P<0.05）。N组与B组T1最大抑制程度均随药量的增加而增大（P<0.05）。结论 肥胖影响年轻女性患者罗库溴铵的量效曲线,使其对罗库溴铵的敏感性增强,肥胖女性罗库溴铵ED95为0.251 mg/kg。
英文摘要:
      Objective To observe the effects of obesity on dose response curve of rocuronium in female patients and calculate ED95 of rocuronium. Methods Eighty female patients, aged 18-45 years, falling into ASA grade Ⅰ or Ⅱ, schedualed for elective surgery under general anesthesia, undergoing surgery less than 1.5 h, were included in the study. The patients with body mass index of 20-25 kg/m2 as group N were randomized to divided group N1, group N2, group N3 and group N4. Another 40 patients with body mass index of 30-35 kg/m2 as group B were randomized to divided group B1,group B2,group B3 and group B4. When the first twitch height of TOF (T1) was 100％,groups N1-N4 and groups B1-B4 patients were injected rocuronium 0.075,0.1,0.15,0.3 mg/kg respectively. The first dose of rocuronium in each group, T1 maximum inhibition degree and onset time were recorded. The relationship between probit transformed depression of T1 and the logarithm dose of rocuronium was analyzed by linear regression. ED50and ED95of rocuronium in obese and normal body weight patients were calculated. Results Dose response curve equation of each group were Y1=3.464X1-2.230 and Y2=3.843X2-2.750 respectively(P＜0.05). The ED50 and ED95(95％CI) of rocuronium were 0.122(0.092 -0.165) mg/kg and 0.324 (0.242-0.433) mg/kg in group N, and were 0.103 (0.078-0.133)mg/kg and 0.251(0.193-0.326)mg/kg in group B. Conclusion Obesity significantly affects the dose response curve of young women and can enhance the sensitivity of them to the rocuronium.The ED95 of obese patients is 0.251 mg/kg.
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