Ueno Koichi
Graduate School of Pharmaceutical Sciences, Chiba University, Chiba 260-8677.
Masui. 2009 Jan;58(1):51-8.
The gender aspect in pharmacokinetics and pharmacodynamics of anesthetics has attracted little attention. Knowledge of previous work is required to decide if gender-based differences in clinical is justified. Females have 20-30% greater sensitivity to the muscle relaxant effects of vecuronium and rocuronium. When rapid onset of or short duration of action is very important, gender-modified dosing may be considered. Males are more sensitive than females to propofol. It may therefore be necessary to decrease the propofol dose by 30-40% in males compared with females in order to achieve similar recovery times. Females are more sensitive than males to opioid receptor agonists, as shown for morphine as well as for pentazocin. On the other hand, females may experience respiratory depression and other adverse effects more easily if they are given the same doses as males. These examples illustrate that gender should be taken into account as a factor that may be predictive for the dosage of several anesthetic drugs. Moreover, there is an obvious need for more research in this area in order to further optimize drug treatment in anesthesia.
麻醉药的药代动力学和药效学中的性别因素很少受到关注。需要了解先前的研究工作，以确定临床上基于性别的差异是否合理。女性对维库溴铵和罗库溴铵的肌肉松弛作用的敏感性要高20% - 30%。当快速起效或短作用时间非常重要时，可以考虑根据性别调整剂量。男性对丙泊酚比女性更敏感。因此，与女性相比，男性可能需要将丙泊酚剂量降低30% - 40%，以达到相似的恢复时间。女性对阿片受体激动剂比男性更敏感，吗啡和喷他佐辛的情况就是如此。另一方面，如果给予女性与男性相同的剂量，她们可能更容易出现呼吸抑制和其他不良反应。这些例子说明，性别应作为一个可能预测几种麻醉药物剂量的因素加以考虑。此外，显然需要在这一领域进行更多研究，以便进一步优化麻醉中的药物治疗。
