【摘要】 目的　用单次剂量法评估罗库溴铵在老年人和中年人剂量反应的差异 ,并探讨其可能的机制。方法　择期全麻手术患者 80例 ,分成中青年组 (30～ 4 5岁 )和老年组 (>6 5岁 ) ,每组 4 0例。按罗库溴铵用量将老年组再分成 10 0、15 0、2 0 0、2 5 0和 2 75 μg/kg五个亚组 ,中青年组分为 10 0、15 0、2 0 0、2 5 0和 30 0 μg/kg五个亚组 ,每亚组 8例。丙泊酚和芬太尼诱导及手控气囊面罩通气下 ,用加速度仪以连续 4次刺激方式刺激尺神经 ,获取静脉注射罗库溴铵后T1最大抑制 (Tmax)程度和时间。结果　老年组罗库溴铵的ED50 、ED90 和ED95分别为 (115 0 8± 35 10 ) μg/kg、(2 4 7 4 4± 32 95 )μg/kg和 (2 6 3 10± 34 15 ) μg/kg ,中青年组分别为 (15 0 5 0± 2 9 2 8) μg/kg、(2 74 0 4± 30 6 3) μg/kg和 (2 89 4 9± 31 70 ) μg/kg。老年组的ED50 、ED90 及ED95分别是中青年组的 76 %、90 3%和 91 2 %(P <0 0 1)。老年组的血清钾、血浆总蛋白和白蛋白浓度低于中青年组 (P <0 0 5 )。结论　罗库溴铵在正常体重老年人的作用强度大于中青年。年龄组间罗库溴铵作用强度的差异可能与电解质和血浆蛋白水平的差异有关更多还原

【Abstract】 Objective To determine the difference and possible mechanism of dose response relationship of rocuronium between the elderly and young adult with single bolus dose response technique.Method 80 patients scheduled for selective surgical procedure under general anesthesia were studied.The patients were divided into elderly group(>65yrs.)and young group(30-45yrs.)with 40 cases each.Each group was divided into five subgroups according to five different rocuronium doses:100,150,200,250 and 275μg/kg in the elderly group,and 100,150,200,250 and 300μg/kg in the young group,respectively,with 8 cases in each subgroup.An accelerometer was used to monitor the neuromuscular transmission function by stimulating the ulnar nerve with train of four stimulation to obtain the maximal depression of twitch height of T 1(T max )and the lag time after rocuronium injected intravenously.Results The ED 50 ,ED 90 and ED 95 were (115 08±35 10)μg/kg,(247 44±32 95)μg/kg and (263 99±34 15)μg/kg for the elderly,and (150 50±29 28)μg/kg,(274 04±30 63)μg/kg and (289 49±31 70)μg/kg for the young,respectively.The ED 50 ,ED 90 and ED 95 of the elderly were respectively 76%,90 3% and 91 2% of those in young adults( P< 0 01).The concentration of serum potassium,total plasma protein,and albumin was significantly lower in the elderly than that in its counterpart( P< 0 05).Conclusion In the elderly with normal body weight,rocuronium has a more potent action than that in the young.This difference of potency of rocuronium is possibly related to the difference of the concentration of serum potassium,and plasma total protein and albumin between the elderly and young. [更多还原