不同浓度7氟醚对顺式阿曲库铵肌松效应的影响.docVIP

不同浓度七氟醚对顺式阿曲库铵肌松效应的影响 夏瑞 罗高平 毛庆军 卢娟 夏晓东 吴芳 长江大学附属第一医院麻醉科 434000 【摘要】目的 以丙泊酚为对照，研究不同浓度七氟醚对顺式阿曲库铵肌松效应的影响。方法 60例腹部手术患者，随机分为丙泊酚组（Ⅰ组）、1MAC（1.7%）七氟醚组（Ⅱ组）和1.3MAC（2.2%）七氟醚组（Ⅲ组），分别在插管后靶控输注丙泊酚或吸入相应浓度的七氟醚，然后注入2ED95的顺式阿曲库铵，待T1恢复至5%左右后接微量泵输注顺式阿曲库铵维持T1在3～5%，监测并记录各组顺式阿曲库铵的起效时间，T1恢复至5%的时间，每30min的输注速率，以及T125%和75%恢复时间及恢复指数。结果 与Ⅰ组比较，Ⅱ组和Ⅲ组的起效时间明显缩短，T1恢复到5%的时间明显延长，输注30min、60min、90min时的速率明显减慢，差异有显著性（p＜0.01），Ⅱ组与Ⅲ组T1的25%和75%恢复时间明显延长，差异有显著性（Ⅱ组，p＜0.05，Ⅲ组，p＜0.01）；与Ⅱ组比较，Ⅲ组的起效时间明显缩短（p＜0.01），输注60min时的速率明显减慢（p＜0.05），差异有显著性；与输注30min时的速率比较，Ⅱ组和Ⅲ组在输注60min、90min时的速率均减低，差异有显著性（p＜0.05）。结论 七氟醚能明显延长顺式阿曲库铵的作用时间，有时间依赖及剂量依赖趋势。 【关键词】 顺式阿曲库铵；七氟醚；神经肌肉阻滞；药物相互作用 The effects of different concentration of sevoflurane on muscle relaxation produced by cisatracurium 【Abstract】Objective To evaluate the potentiation effects of different concentrations of sevoflurane on neuromuscular block of cisatracurium．Methods Sixty ASA class I orⅡ patients，aged 29 to 61 years old，undergoing selective surgery under general anesthesia were randomly divided into three groups with 20 cases each.They were anesthetized to receive propofol(groupⅠ,n=20),1MAC(1.7%) end-tidal concentration of sevoflurane(groupⅡ,n=20) and 1.3MAC(2.2%) end-tidal concentration of sevoflurane(groupⅢ,n=20),respectively. Neuromuscular block(N-M block)was monitored using train-of-four(TOF)stimulation by recording the force of contraction of adductor policis muscle with a muscle relaxation monitor(TOF Watch Sx)．15mins after endotracheal intubation,cisatracurium 0.1mg.kg-1 was administered,then followed by continuous IV infusion adjusted manually to maintain T1 at the level from 3% to 5%.the onset time, the time of T1 spontaneous recovery to 5%,the infusion rates every 30mins,the spontaneous recovery index(T25-75) )and the time interval from T1 at 5％ of control to recovery of T1 to 25%and 75% were recorded. Results the onset time of cisatracurium, the infusion rates, were significantly shorter in groupⅡand groupⅢ than groupⅠ,while the t