在儿科重症监护病房持续输注罗库溴铵。

Continuous infusion of rocuronium in a paediatric intensive care unit.

作者信息

Tobias J D

机构信息

Department of Child Health, University of Missouri, Columbia 65212, USA.

出版信息

Can J Anaesth. 1996 Apr;43(4):353-7. doi: 10.1007/BF03011713.

DOI:10.1007/BF03011713

PMID:8697549

Abstract

PURPOSE

To evaluate prospectively the efficacy and dose requirements of rocuronium administered by continuous infusion for neuromuscular blockade in a paediatric ICU population.

METHODS

Neuromuscular function was monitored by train-of-four (TOF) stimulation of the ulnar or peroneal nerve. Rocuronium was administered as a bolus dose (0.6 mg.kg-1) followed by a continuous infusion starting at 0.6 mg.kg-1.hr-1. The infusion was increased or decreased by 0.1 mg.kg-1.hr-1 to maintain one visible twitch of the TOF. All patients also received a benzodiazepine or a barbiturate infusion.

RESULTS

The study population included 20 patients (12 boys, eight girls) ranging in age from two months to 16 yr and in weight from 3.6 to 64 kg. The duration of the rocuronium infusion varied from 26 to 172 hr for a total of 1492 hr in the 20 patients. The rocuronium infusion requirements for day 1 varied from 0.3 to 0.8 mg.kg-1.hr-1 (0.76 +/- 0.3 mg.kg-1.hr-1). When considering all patients and all patient days, the rocuronium infusion rate required to maintain one twitch of the TOF varied from 0.3 to 2.2 mg.kg-1.hr-1 (mean for all patient days = 0.95 +/- 0.4 mg.kg-1.hr-1). The infusion requirements were 0.5 to 0.8 mg.kg-1.hr-1 in 45 of the 64 patient days (70%) and 0.3 to 1.0 mg.kg-1.hr-1 in 58 of the 64 patient days (90%). No problems with the infusion were noted.

CONCLUSIONS

Continuous infusion of rocuronium can be used to provide neuromuscular blockade in the paediatric ICU patient. Due to the variability in infusion requirements, monitoring of neuromuscular function is suggested.

摘要

目的

前瞻性评估在儿科重症监护病房（ICU）患者中持续输注罗库溴铵用于神经肌肉阻滞的疗效和剂量需求。

方法

通过对尺神经或腓总神经进行四个成串刺激（TOF）来监测神经肌肉功能。先给予罗库溴铵静脉推注剂量（0.6mg·kg⁻¹），随后以0.6mg·kg⁻¹·h⁻¹开始持续输注。根据TOF保持一个可见肌颤搐的情况，将输注速率每小时增加或减少0.1mg·kg⁻¹·h⁻¹。所有患者还接受苯二氮䓬类或巴比妥类药物输注。

结果

研究人群包括20例患者（12例男孩，8例女孩），年龄从2个月至16岁，体重从3.6kg至64kg。20例患者罗库溴铵输注持续时间从26小时至172小时不等，总计1492小时。第1天罗库溴铵输注需求量从0.3mg·kg⁻¹·h⁻¹至0.8mg·kg⁻¹·h⁻¹（0.76±0.3mg·kg⁻¹·h⁻¹）。考虑所有患者和所有患者日，维持TOF一个肌颤搐所需的罗库溴铵输注速率从0.3mg·kg⁻¹·h⁻¹至2.2mg·kg⁻¹·h⁻¹（所有患者日的平均值 = 0.95±0.4mg·kg⁻¹·h⁻¹）。64个患者日中的45个（70%）输注需求量为0.5mg·kg⁻¹·h⁻¹至0.8mg·kg⁻¹·h⁻¹，64个患者日中的58个（90%）输注需求量为0.3mg·kg⁻¹·h⁻¹至1.0mg·kg⁻¹·h⁻¹。未发现输注相关问题。