使用闭环计算机控制系统在不同年龄组中使用顺式阿曲库铵的情况。

Consumption of Cisatracurium in different age groups, using a closed loop computer controlled system.

作者信息

Joomye Shehzaad, Yan Donglai, Wang Haiyun, Zhou Guoqiang, Wang Guolin

机构信息

Department of Anaesthesiology, Tianjin Medical University General Hospital, Tianjin Research Institute of Anaesthesiology, No. 154 Anshan Road, Heping District, 300052 Tianjin, China.

Department of Anaesthesiology, Tianjin Second People's Hospital, NO.7 South Road, Nankai District, 300192 Tianjin, China.

出版信息

BMC Anesthesiol. 2014 Apr 21;14:29. doi: 10.1186/1471-2253-14-29. eCollection 2014.

DOI:10.1186/1471-2253-14-29

PMID:24745306

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4021420/

Abstract

BACKGROUND

We devised this study to quantify the effect of age on the consumption of cisatracurium under general anaesthesia, using a computer controlled closed loop infusion system. We further investigated this effect on, sufentanil and propofol consumption.

METHODS

74 patients of physical status I and II, requiring general anaesthesia for elective abdominal surgery, were assigned to three groups. Patients in group 1 were aged from 20 to 45, group 2 were from 46 to 64, and group 3 above 65 years old. General Anesthesia was maintained with propofol and muscle paralysis was maintained using a closed-loop computer controlled infusion of cisatracurium. For analgesia, intermittent bolus of sufentanil 10 μg was given.

RESULTS

Cisatracurium consumption in group 1, 2 and 3 were 1.8 ± 0.3, 1.6 ± 0.4 and 1.3 ± 0.4 μg/kg/min respectively. There was significant difference of cisatracurium consumption between group 1 and 3 (P = 0.002), and the consumption of cisatracurium in group 3 was less as compared with group 2 (P = 0.04). The average recovery index of patients in group 1, 2 and 3 were 8.8 ± 2.6, 11.5 ± 2.9 and 12.7 ± 2.5 minutes respectively. There were difference between group 1 and 2 (P = 0.02). As compared with group 1, the recovery index was still longer in group 3 (P = 0.001). Patients in group 1, 2 and 3 consumed an average sufentanil 0.4 ± 0.1, 0.4 ± 0.1 and 0.3 ± 0.1 μg/kg/hr, respectively. There were statistical significant between group 1 and 3 (P < 0.0001), and the same trend was found between group 2 and 3 (P = 0.03). The Consumption of propofol in group 1, 2 and 3 were 5.1 ± 0.4, 4.3 ± 0.6 and 3.1 ± 0.5 mg/kg/hr. The difference in the propofol consumption was found statistically significant when comparing between any two groups.

CONCLUSION

We concluded that the sensitivity of anesthetic agents increased with age. Less medication was required to achieve a desirable effect in older patients specially those above 65 years of age, and the drug effect was prolonged.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT01785446.

摘要

背景

我们设计了本研究，使用计算机控制的闭环输注系统来量化年龄对全身麻醉下顺式阿曲库铵用量的影响。我们还进一步研究了年龄对舒芬太尼和丙泊酚用量的影响。

方法

74例身体状况为Ⅰ级和Ⅱ级、需要接受择期腹部手术全身麻醉的患者被分为三组。第1组患者年龄在20至45岁之间，第2组年龄在46至64岁之间，第3组年龄在65岁以上。使用丙泊酚维持全身麻醉，并通过闭环计算机控制输注顺式阿曲库铵来维持肌肉麻痹。为进行镇痛，给予10μg舒芬太尼的间歇性推注。

结果

第1组、第2组和第3组的顺式阿曲库铵用量分别为1.8±0.3、1.6±0.4和1.3±0.4μg/（kg·min）。第1组和第3组之间顺式阿曲库铵用量存在显著差异（P = 0.002），与第2组相比，第3组顺式阿曲库铵用量较少（P = 0.04）。第1组、第2组和第3组患者的平均恢复指数分别为8.8±2.6、11.5±2.9和12.7±2.5分钟。第1组和第2组之间存在差异（P = 0.02）。与第1组相比，第3组的恢复指数仍然更长（P = 0.001）。第1组、第2组和第3组患者的舒芬太尼平均用量分别为0.4±0.1、0.4±0.1和0.3±0.1μg/（kg·hr）。第1组和第3组之间存在统计学显著差异（P < 0.0001），第2组和第3组之间也发现了相同趋势（P = 0.03）。第1组、第2组和第3组的丙泊酚用量分别为5.1±0.4、4.3±0.6和3.1±0.5mg/（kg·hr）。在任意两组之间比较时，丙泊酚用量的差异具有统计学意义。