关键词:

舒更葡糖钠, 罗库溴铵, 半数有效剂量, 95%有效剂量

Abstract:

Objective To investigate the dose⁃response relationship of sugammadex sodium to reverse the neuromuscular block effect of rocuronium and calculate the 50% effective dose（ED50）and 95% effective dose （ED95）of sugammadex sodium. Methods A total of 50 adult patients who planned to undergo elective ear，nose， and throat surgery in our hospital from June 2020 to June 2021 were selected. Age 18 ~ 65 years，ASA GRADE Ⅰ~ Ⅱ，body mass index（BMI）18.5 ~ 27.9 kg/m2，ear，nose，and throat surgery performed under general anesthesia， and expected surgical duration > 90 minutes are all inclusion criteria. Dixon sequential method was used to adjust the dose of sugammadex sodium. The first patient received an initial intravenous dose of sugammadex sodium 4 mg/kg with a dose gradient of 0.5 mg/kg. If the neuromuscular block effect of rocuronium was successfully reversed in the previous patient，the dose of sugammadex sodium was reduced by a gradient in the next patient；If the neuromuscular blocking effect of rocuronium was not reversed in the previous patient ，the dose of sugammadex sodium was increased by a gradient in the next patient. Follow the preceding rules until 50 patients have been included. In all patients，the success or failure of recovery from neuromuscular block was recorded. HR and MAP were measured prior to，immediately following，1 minute，2 minutes，and 5 minutes after sugammadex sodium injection. Following extubation，the patient was transferred to the PACU for 1 hour of observation，during which time the occurrences of hypotension，bradycardia，nausea and vomiting，dizziness，and allergic reactions were recorded. Results The ED50 and ED95 of sugammadex sodium to reverse the neuromuscular block effect of rocuronium were 3.481 mg/kg （95%CI：3.310 ~ 3.652）and 4.178 mg/kg（95%CI：3.769 ~ 4.587）. Patients were divided into sugammadex sodium 4 mg/kg group（S4 group）sugammadex sodium 3.5 mg/kg group（S3.5 group）and sugammadex sodium 3 mg/kg group（S3 group）according to the specific value of ED50 and ED95 and sample size of each dose，each group includ⁃ ed 12，22 and 13 patients，respectively. There were no significant differences in HR and MAP before，immediate⁃ ly after，1 min，2 min and 5 min after sugammadex sodium injection among the three groups（P > 0.05）. There were no significant differences in HR and MAP between the S4 and S3 groups at any time point（P > 0.05）. The HR of patients in S3.5 group at 1 min，2 min and 5 min after injection was significantly lower than that of before injec⁃ tion，with statistical significance（P < 0.05）. There was no significant difference in the incidence of hypotension， bradycardia，nausea and vomiting，dizziness，and allergic reaction among 3 groups（P > 0.05）. Conclusion Dif⁃ ferent doses of sugammadex sodium can reverse the neuromuscular block effect of rocuronium. The larger the dose， the stronger the block effect. At the same time，attention should be paid to prevent adverse reactions such as bra⁃ dycardia during medication.

Key words:

sugammadex sodium, rocuronium, dose?response relationship, 95% effective dose