【摘要】 目的观察顺式阿曲库铵用于肥胖患者的肌松作用。方法 ASAⅠ～Ⅲ级的择期气管内全身麻醉患者30例,按体重指数BMI分组:Ⅰ组正常体重对照组,BMI18.5～25kg/m2,Ⅱ组和Ⅲ组均为肥胖组,BMI30～40kg/m2。Ⅰ组和Ⅱ组按照实际体重、Ⅲ组按照理想体重分别给予0.15mg/kg(3ED95)顺式阿曲库铵。采用TOF-WatchSX肌松监测仪进行拇内收肌肌松监测。采用全凭静脉诱导及维持。T1/Tc<10%时气管插管。记录起效时间(从肌松药注毕至T1消失的时间)、作用时效(注药结束到T1恢复至对照Tc25%的时间)、恢复指数(T1从25%恢复到75%的时间)以及气管插管条件评级。结果起效时间在Ⅱ组缩短、Ⅲ组延长,但与Ⅰ组相比差异均无显著性(P>0.05);作用时效在Ⅱ组与Ⅰ组和Ⅲ组相比均显著延长(P<0.05),Ⅲ组时效最短,与Ⅰ组和Ⅱ组相比差异均有显著性(P<0.05,P<0.01);恢复指数和插管条件在3组间差异均无显著性(P>0.05)。结论 3ED95的顺式阿曲库铵时用于肥胖患者时,按实际体重给药作用时效延长;按理想体重给药,时效缩短;恢复指数和插管条件没有差异。顺式阿曲库铵用于肥胖患者可预测性良好,用于短小手术建议按理想体重给药。更多还原

【Abstract】 【Objective】To investigate the muscle relaxation of Cisatracurium in obese patients.【Methods】30 patients classified ASAⅠ～Ⅲ undergoing elective general anesthesia were divided into 3 groups:group Ⅰ(normal body weight as a control group) with BMI 18.5～25 kg/m2;groupⅡ and group Ⅲ both were obesity groups with BMI 30～40 kg/m2.Group Ⅰ and groupⅡ received cisatracurium 0.15 mg/kg based on real body weight while group Ⅲ received cisatracurium 0.15 mg/kg based on ideal body weight.Neuromuscular block at adductor pollicis was monitored by a TOF-Watch SX accelerograph.Anesthesia was induced and maintained by total intravenous drugs.Intubation was attemped after the first twitch height became less than 10% of baseline.The onset time(time from end of bolus injection to 100% twitch depression),clinical duration(time from the end of bolus injection to recovery of twitch tension to 25% of control),recovery index(the time lapse from 25% to 75% of recovery of T1) and tracheal intubation conditions were recorded.【Results】The onset time was shortened in group Ⅱ and prolonged in group Ⅲ but didn’t achieve statistical significance when compared to groupⅠ(P >0.05);clinical duration was significantly different among the groups(P <0.05),group Ⅱ was the longest and group Ⅲ was the shortest;recovery index or tracheal intubation conditions were not significant different among the groups(P >0.05).【Conclusion】Cisatracurium presented good prediction in obese patients.When applied in short minor surgery on the obese,we recommended dosage based on ideal body weight.It can provide a shorter duration of cisatracurium and without a significant prolonged onset or a worse intubation condition.更多还原