The effect of different doses of vecuronium on respiratoty function and mechanics during laparoscopic cholecystectomy  

作　　者：徐世元 

机构地区：[1]Dept Anesthesiol Zhujiang,Hosp, 1st Mil Med Univ PLA, Guangzhou 510282

出　　处：《外科研究与新技术》2003年第2期70-71,共2页Surgical Research and New Technique

摘　　要：Objective To investigate the effects of different doses of vecuronium on ventilatory function and mechanics of breathing during elective laparoscopic cholecystectomy. Methods Sixty - three ASA Ⅰ - Ⅱ patients aged 29 -57 yr were randomly divided into 3 groups of twenty-one: group Ⅰ received vecuronium 1 ± ED95 , group Ⅱ 2 ± ED95 and group Ⅲ ± ED95. Patients with respiratory disease were excluded. The patients were premedicated with intramuscular scopolamine 0 . 3 mg and oral diazepam 0 . 1 mg· kg-1 . Anesthesia was induced with fentanyl 2 μg ·kg-1 ,propofol 2 mg·kg-1 and succinylcholine 1. 5 mg· kg-1 and maintained with 1.0% -1.5% isoflurance and intermittent iv boluses of propofol 1 mg·kg when needed. Vecuronium 1 ± ED95 ( group Ⅰ ) or 2 ± ED95 (group Ⅱ ) or 3 ± ED95 (group Ⅲ ) was given iv after succinylcholine when TOF showed that T1 】 70 % . The patients were mechanically ventilated. VT was set at 10 ml ·kg-1 and respiratory rate at 12 bpm. End-tidal PCO2 was maintained at 30 -Objective To investigate the effects of different doses of vecuronium on ventilatory function and mechanics of breathing during elective laparoscopic cholecystectomy. Methods Sixty - three ASA Ⅰ - Ⅱ patients aged 29 -57 yr were randomly divided into 3 groups of twenty-one: group Ⅰ received vecuronium 1 ± ED95 , group Ⅱ 2 ± ED95 and group Ⅲ ± ED95. Patients with respiratory disease were excluded. The patients were premedicated with intramuscular scopolamine 0 . 3 mg and oral diazepam 0 . 1 mg· kg-1 . Anesthesia was induced with fentanyl 2 μg ·kg-1 ,propofol 2 mg·kg-1 and succinylcholine 1. 5 mg· kg-1 and maintained with 1.0% -1.5% isoflurance and intermittent iv boluses of propofol 1 mg·kg when needed. Vecuronium 1 ± ED95 ( group Ⅰ ) or 2 ± ED95 (group Ⅱ ) or 3 ± ED95 (group Ⅲ ) was given iv after succinylcholine when TOF showed that T1 > 70 % . The patients were mechanically ventilated. VT was set at 10 ml ·kg-1 and respiratory rate at 12 bpm. End-tidal PCO2 was maintained at 30 - 35 mmHg. End- tidal PCO2,SpO2, ECG and BP were continuously monitored. The respiratory function and mechanics were measured using respiratory monitor CP- 100(BICORE) before and after pneumoperitoneum ( intra-abdominal pressure reached 15 mmHg) and 5, 10, 15, 20, 25, 30, 35 min after vecuronium. The respiratory parameters measured included inspiratory and expiratory VT(VTi, VTe) , minute ventilation (VE), respiratory rate (RR),peak inspiratory and expikratory flow rate ( PIFR, PEFR) , PEEP, auto-PEEP, pressure-time product ( FTP ) , inspiratory- time ratio (T1/TTOT) , rate/VT ratio, average airway pressure (PAWM) , esophageal pressure (PES) , peak inspiratory pressure ( PIP ) , dynamic compliance ( CDyn ) , airway resistance (RAW) and work of breathing. Results There was no significant difference in the effect of different doses of vecuronium on respiratory function and mechanics including all parameters measured at all time points among the three groups. Mean airway pressure, esophageal pressure pe

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分 类 号：R657.4[医药卫生—外科学]