新辅助化疗对胃癌手术患者罗库溴铵药效学影响

doi:10.12092/j.issn.1009-2501.2019.10.012

中国临床药理学与治疗学 ›› 2019, Vol. 24 ›› Issue (10): 1161-1164.doi: 10.12092/j.issn.1009-2501.2019.10.012

新辅助化疗对胃癌手术患者罗库溴铵药效学影响

连燕虹¹，姜慧芳¹，袁晓红¹，周惠丹¹，解康杰¹，方军¹，金孝岠²

¹中国科学院肿瘤与基础医学研究所，中国科学院大学附属肿瘤医院，浙江省肿瘤医院麻醉科，杭州 310022，浙江；²皖南医学院附属弋矶山医院麻醉科，芜湖 241001，安徽

收稿日期:2019-07-15 修回日期:2019-09-18 出版日期:2019-10-26 发布日期:2019-10-28
作者简介:连燕虹，女，本科，副主任医师，研究方向：麻醉生理与药理学研究。 Tel：0571-88122106 E-mail：lianyanhong2007@126.com
基金资助:
浙江省医药卫生科技项目（2017KY027）；浙江省自然科学基金（LQI5H020001）

Effects of neoadjuvant chemotherapy on the pharmacodynamics of rocuronium bromide in patients undergoing gastric cancer surgery

LIAN Yanhong¹, JIANG Huifang¹, YUAN Xiaohong¹, ZHOU Huidan¹, XIE Kangjie¹, FANG Jun¹, JIN Xiaoju²

¹Department of Anesthesiology, Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou 310022, Zhejiang, China; ² Department of Anesthesiology, Yijishan Hospital of Wannan Medical College, Wuhu 241001, Anhui, China

Received:2019-07-15 Revised:2019-09-18 Online:2019-10-26 Published:2019-10-28

摘要/Abstract

摘要：

目的:观察新辅助化疗对胃癌手术患者罗库溴铵药效学影响。方法:50例择期行开放胃癌根治术患者，ASA分级Ⅰ或Ⅱ，性别不限，年龄40～68岁，体质量56～79 kg，25例术前未做化疗（N组），25例术前行新辅助化疗（C组）。静脉诱导患者入睡后，给予罗库溴铵0.9 mg/kg，当4次成串刺激（TOF）为0时插入气管导管，T1恢复至对照值25%时追加罗库溴铵0.15 mg/kg。记录罗库溴铵起效时间（给药至T1为0时间，t1）、首剂作用时间（首次给药至T1达25%时间，t2）、临床肌松时间（T1从0恢复至25%时间，t3）、恢复指数（T1从25%恢复至75%所需时间，RI）和拔管时间（停用肌松药至T4/T1恢复至90%时间，t4）和罗库溴铵的总用量。结果:与N组相比，C组肌松药首次作用时间延长，临床肌松时间延长，术中总用量减少，恢复指数和拔管时间延长（P<0.05）。两组患者起效时间无统计学差异（P>0.05）。结论:新辅助化疗可减少术中肌松药的使用量。

关键词: 化疗, 罗库溴铵, 药效动力学, 胃癌

Abstract:

AIM: To evaluate the effect of neoadjuvant chemotherapy on neuromuscular block induced by rocuronium in the patients undergoing radical gastrectomy. METHODS:Fifty patients with open gastric cancer, ASA Ⅰ or Ⅱ, aged 40 to 68 years old, 56-79 kg, scheduled for elective radical gastrectomy, were divided into 2 groups (n=25 each) according to whether the patient received neoadjuvant chemotherapy before operation or not: non-chemotherapy group (group N) and neoadjuvent chemotherapy group (group C). Anesthesia was induced with rocuronium 0.9 mg/kg injected intravenous. When T1 recovered to 25% of control height, IV infusion of rocuronium 0.15 mg/kg was used. The onset time, time for T1 to recover to 25%, recovery index and time for train of four ratios to recover to 90%, and the total amount of rocuronium were recorded. RESULTS:Compared with the group N, time for T1 to recover to 25%, recovery index and time for train of four ratios to recover to 90% were significantly prolonged, and the consumption of rocuronium was decreased in group C. There was no significant difference of onset time between the two groups. CONCLUSION:Neoadjuvant chemotherapy can reduce the usage of muscle relaxant in the patients undergoing radical gastrectomy.

Key words: chemotherapy, rocuronium bomide, pharmacodynamics, gastric cancer

中图分类号:

R749

连燕虹，姜慧芳，袁晓红，周惠丹，解康杰，方军，金孝岠. 新辅助化疗对胃癌手术患者罗库溴铵药效学影响[J]. 中国临床药理学与治疗学, 2019, 24(10): 1161-1164.

LIAN Yanhong, JIANG Huifang, YUAN Xiaohong, ZHOU Huidan, XIE Kangjie, FANG Jun, JIN Xiaoju. Effects of neoadjuvant chemotherapy on the pharmacodynamics of rocuronium bromide in patients undergoing gastric cancer surgery[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2019, 24(10): 1161-1164.

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新辅助化疗对胃癌手术患者罗库溴铵药效学影响

Effects of neoadjuvant chemotherapy on the pharmacodynamics of rocuronium bromide in patients undergoing gastric cancer surgery

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