目的: 观察罗库溴铵在长寿老年人（≥90岁）、中等寿老年人（75~89岁）、年轻老年人（60~74岁）和中年人(45~59岁)单次和重复静脉注射的肌松效应。方法: 研究纳入长寿老年人、中等寿老年人、年轻老年人各20例,美国麻醉医师协会（American Society of Anesthesiology,ASA）Ⅱ~Ⅲ级,另以中年病人20例,ASA Ⅱ级作为对照。麻醉诱导以咪达唑仑0.02 mg/kg、舒芬太尼0.4 μg/kg、异丙酚1.5~2.0 mg/kg静脉注射。然后在10 s内静脉注射罗库溴铵0.5 mg/kg,待4个成串刺激后第1个肌颤搐（T₁）完全消失时行气管插管。麻醉维持以异丙酚5~12 mg/（kg·h）静脉泵推注,间断静脉注射舒芬太尼。T₁恢复至对照值（T_c）的25%时,追加罗库溴铵0.1 mg/kg,以维持肌松。结果: ①诱导剂量的罗库溴铵在长寿老年人、中等寿老年人、年轻老年人和中年人组的起效时间、无反应期、T₁/T_c 25%恢复时间差异均有统计学意义。长寿老年人、中等寿老年人、年轻老年人起效比中年人快（P<0.05）,年龄越大,起效越快。长寿老年人、中等寿老年人、年轻老年人无反应期、T₁/T_c 25%恢复时间比中年人长,且年龄越大,时间越长（P<0.05）。长寿老年人相对应时间最长。②各次追加药的无反应期、T₁/T_c 25%恢复时间,随着追加次数增多有逐渐延长的趋势。长寿老年人、中等寿老年人、年轻老年人时间比中年人长,且年龄越大,时间越长。③用新斯的明拮抗罗库溴铵明显缩短T₁/T_c 75%恢复时间（P<0.05）。长寿老年人、中等寿老年人、年轻老年人T₁/T_c 75%恢复时间比中年人长,且年龄越大,时间越长。结论: 罗库溴铵在长寿老年人、中等寿老年人、年轻老年人起效都比中年人快。长寿老年人、中等寿老年人、年轻老年人无反应期、T₁/T_c 25%恢复时间都比中年人长。随着追加罗库溴铵次数增多,相应时间有逐渐延长的趋势,且年龄越大,时间越长。

Objective To investigate the muscle relaxation by a loading dose followed repeat of rocuronium in elderly patients with ASA Ⅱ-Ⅲ including longevity old patients ≥90 years, middle old patients 75-89 years and young old patients 60-74 years and in middle-aged patients 45-59 years with ASA Ⅱ. Methods Longevity old patients (n=20), middle old patients (n=20) and young old patients (n=20) were investigated with middle-aged patients (n=20) as control. Anesthesia was induced with intravenous midazolam 0.02 mg/kg, sufentanyl 0.4 μg/kg and propofol 1.5-2.0 mg/kg. Intubation was done after the first twitch (T₁) disappeared following train of four stimuli after a loading dose of rocuronium 0.5 mg/kg intravenously within 10 seconds. Anesthesia was maintained with propofol at a rate of 5-12 mg/(kg·h) by infusion pump with intravenous bolus of sufentanyl. The first twitch (T_c) as control was measured before rocuronium was administered. Muscle relaxation was maintained with increment of rocuronium 0.1 mg/kg when T₁ returned to 25% of T_c. Results ①There was significant difference in onset time, no response time and time of 25% recovery of T₁/T_c after induction dose of rocuronium between elderly patients and middle-aged patients (P<0.05). Onset time was shorter in elderly patients than in middle-aged patients (P<0.05) which related with age, and shortest in longevity old patients. No response time and time of 25% reco-very of T₁/T_c were longer in elderly patients than in middle-aged patients (P<0.05), and longest in longevity old patients. ②No response time and time of 25% recovery of T₁/T_c increased with increasing in numbers of incremental doses. The duration was longer in elderly patients than in middle-aged patients which related with age. ③Neostigmine shortened the time of 75% recovery of T₁/T_c in all of the patients significantly (P<0.05). Duration of 75% recovery of T₁/T_c was longer in elderly patients than in middle-aged patients which related with age. Conclusions Onset time of rocuronium was shorter in elderly patients including longevity old patients, middle old patients and young old patients than in middle-aged patients. No response time and time of 25% recovery of T₁/T_c were longer in elderly patients than in middle-aged patients. The duration increased with increasing numbers of incremental doses.