中青年论文评奖临床麻醉与研究不同浓度七氟烷对顺式阿曲库铵肌松.doc

中青年论文评奖 临床麻醉与研究 不同浓度七氟烷对顺式阿曲库铵肌松作用的影响 中国医科大学麻醉科 110001 王志 马虹 【摘要】 目的 观察不同浓度七氟烷对顺式阿曲库铵肌松作用的影响。方法 择期全麻手术患者60例，ASA I或Ⅱ级，年龄18～60岁，体重40～80 kg，身高150～180cm,随机分为4组(n=15): 丙泊酚组（P组）、1%七氟烷组（S1 组）、1.5%七氟烷组（S1.5 组）、2%七氟烷组（S2 组）。麻醉诱导后P组丙泊酚-瑞芬太尼维持，S1、S1.5、S2 组分别吸入1％、1.5、2％浓度的七氟烷。维持35 min 后，各组均静脉注射顺式阿曲库铵0.15 mg/kg 。纪录从静脉注射顺式阿曲库铵完毕至肌颤搐(Th)降至0的时间（T0，即起效时间），Th 恢复至50％ 、90％的时间（RT50 、RT90）、临床作用时间（从注射完毕至RT25的时间）和恢复指数（从RT25至RT75的时间, 即RI）。结果 与P组相比，S2组T0缩短，S1、S1.5、S2 组RT50 、RT90、RI、临床作用时间延长（P0.05）；与S1组相比，S1.5、S2 组临床作用时间、RT50 、RT90延长（P0.05）。 结论：吸入2%的七氟烷能缩短顺式阿曲库铵起效时间，吸入1%、1.5%、2%的七氟烷延长顺式阿曲库铵的临床作用时间和恢复时间，但吸入1.5%和2%的七氟烷组间恢复时间无显著性差异。 【关键词】七氟烷；顺式阿曲库铵；神经肌肉阻滞 Effects of sevoflurane on relaxation produced by cisatracurium Wang Zhi,Ma Hong.Department of Anesthesiology,The First Affiliated Hospital of China ,Shenyang,110001，China Corresponding author: Ma Hong(E-mail:Mahong5466@) 【Abstract】 Objective To evaluate the potentiation of neuromuscular block produced by cisatracurium during sevoflurane anesthesia．Methods Sixty ASA I or II patients aged 18～60 yr weighing 40～80kg scheduled for elective surgery under general anesthesia were randomly allocated into 4 groups (n=15 each);group I control (P);group II inhaling 1％ sevoflurane (S1) ;group Ⅲ inhaling 1.5％ sevoflurane (S1..5); group Ⅳ inhaling 2％ sevoflurane (S2).Anesthesia was induced with propofol 1～1.5 mg/kg，fentanyl 2～4ug/kg,Scoline 1mg/kg. Anesthesia was maintained with inhalation of 67％ N20 in 02 combined with propofol-remifentanil(group I)or combined with 1％ sevoflurane (group II)or 1.5％sevoflurane (group Ⅲ)or 2％sevoflurane (group Ⅳ)．The patients were mechanically ventilated．Thirty-five minutes after induction of anesthesia cisatracurium 0.15 mg/kg was given iv in each group. N-M function was monitored with accelerograph F(TOF-WatchSX,Organon,the Netherlands).The electrode was placed at wrist over ulnar nerve. A train of four(TOF)stimulation of ulnar nerve was used. The time from injection of cisa