【罂粟摘要】在80岁以上患者中比较0.3 mg/kg或0.9 mg/kg罗库溴铵的起效时间、作用时间和插管条件：一项随机研究

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贵州医科大学  麻醉与心脏电生理课题组

翻译：马艳燕   编辑：潘志军   审校：曹莹

背景：        

关于老年患者插管时罗库溴铵的最佳剂量的数据有限。我们假设在80岁以上的患者中，0.9 mg/kg罗库溴铵的起效时间比0.3 mg/kg要短。    

方法：        

随机将34名患者分为罗库溴铵0.3 mg/kg组或0.9 mg/kg组。主要结局指标是起效时间，定义为四次连串刺激(TOF)计数为0。其他结局指标包括作用持续时间(时间与TOF之比>0.9)，使用Fuchs-Buder量表评估的插管条件优良率和使用插管难度量表(IDS)评估的气管插管条件。      

结果:    

与罗库溴铵0.3 mg/kg组相比，0.9 mg/kg组起效时间更短，起效时间分别为108秒(SD 40)和228秒(SD 140)(相差119秒 (95%CI：41-196，P=0.005))。然而，在罗库溴铵0.3 mg/kg的患者中，66%的患者TOF计数没有达到0。罗库溴铵0.9 mg/kg组作用时间更长：118分钟(SD 43)比46分钟(SD 13)(相差72分钟(95%CI：49-95，P<0.0001))，插管条件优良率更高(Fuchs-Buder)：11/16(69%)比4/18(22%)(P=0.006)。在IDS评分方面没有发现差异。      

结论:        

在80岁以上的患者中，与罗库溴铵0.3 mg/kg组相比，罗库溴铵0.9 mg/kg组起效时间更短。在罗库溴铵0.3 mg/kg的患者中，66%的患者TOF计数没有达到0。    

原始文献来源：

Vested M, Pape P, Kristensen CM, Dinesen F, Vang M, Christensen RE, Lindahl CB, Albrechtsen C, Rasmussen LS. Rocuronium 0.3 or 0.9mg/kg comparing onset time, duration of action, and intubating conditions in patients 80 years and older: A randomized study. Acta Anaesthesiol Scand. 2022 Jun 8. 

罂粟花      

Rocuronium 0.3 mg/kg or 0.9 mg/kg comparing onset time, duration of action and intubating conditions in patients 80 years and older. A randomized study.  

Background:

 Rocuronium 0.3 mg/kg or 0.9 mg/kg comparing onset time, duration of action and intubating conditions in patients 80 years and older. A randomized study. 

Methods:

Thirty-four patients were randomized to either rocuronium 0.3 mg kg-1 or 0.9 mg kg-1. The primary outcome was onset time defined as time to train-of-four (TOF) count of 0. Other outcomes included duration of action (time to TOF ratio > 0.9), proportion of excellent intubating conditions using the Fuchs-Buder scale and tracheal intubating conditions using the Intubating Difficulty Scale (ID S ). 

Results:

Thirty-four patients were randomized to either rocuronium 0.3 mg kg-1 or 0.9 mg kg-1. The primary outcome was onset time defined as time to train-of-four (TOF) count of 0. Other outcomes included duration of action (time to TOF ratio > 0.9), proportion of excellent intubating conditions using the Fuchs-Buder scale and tracheal intubating conditions using the Intubating Difficulty Scale (ID S ). 

Conclusion:

Rocuronium 0.9 mg kg-1 resulted in a shorter onset time compared to rocuronium 0.3 mg kg-1 in patients above 80 years of age. In 66% of the patients receiving rocuronium 0.3 mg kg-1 a TOF count of 0 was not obtained.

回首向来萧瑟处，归去，也无风雨也无晴。

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