全凭静脉麻醉下预注右美托咪定对罗库溴铵起效时间和作用时间的影响  

The influence of pre-infusion with dexmedetomidine on the onset time and recovery time of rocuronium in total intravenous anesthesia

作　　者：葛帅娜 代志刚[1] 李军[2] 

机构地区：[1]石河子大学医学院第一附属医院麻醉科,新疆石河子市832002 [2]海军总医院麻醉科,北京100048

出　　处：《转化医学杂志》2014年第2期105-107,111,共4页Translational Medicine Journal

摘　　要：目的观察全凭静脉麻醉下预注右美托咪定对罗库溴铵起效时间和作用时间的影响。方法选取50例美国麻醉学会(American Society of Anesthesiology,ASA)Ⅰ~Ⅱ级全身麻醉下行鼻内窥镜手术的患者为研究对象,随机分为右美托咪定组和对照组,每组25例。右美托咪定组于麻醉诱导前15 min开始静脉泵入右美托咪定1.0μg/kg(10 min内泵注完毕),对照组同法输注等量0.9%氯化钠注射液。给予丙泊酚和舒芬太尼全麻诱导,全凭静脉输注丙泊酚及瑞芬太尼麻醉维持。分别记录两组患者麻醉诱导给药前后、气管插管前及插管后1、3、5 min的平均动脉压(mean arterial pressure,MAP),心率(heart rate,HR),脉搏氧饱和度(pulse oxygen saturation,SpO2)值。采用加速度法四个成串刺激(train of four stimulation,TOF)监测肌松,记录罗库溴铵的起效时间和25%、50%、75%、90%的恢复时间。结果右美托咪定组与对照组相比较罗库溴铵的起效时间缩短(P<0.05),两组25%、50%、75%、90%恢复时间的差异均无统计学意义(P>0.05)。结论麻醉诱导前预注右美托咪定可以缩短罗库溴铵的起效时间,但对罗库溴铵的作用时间没有影响。Objective To explore the influence of pre-infusion with dexmedetomidine on the onset time and recovery time of rocuronium in total intravenous anesthesia.Methods Fifty Ameri-can Society of Anesthesiolog (ASA)Ⅰand Ⅱpatients scheduled forendoscopic sinus surgery were included in this study.These patients were randomly divided into dexmedetomidine group (25 pa-tients)and control group (25 patients).Dexmedetomidine 1.0 μg/kg was intravenously infused 15 min prior to induction ofanesthesia in dexmedetomidine group (within 10 min).Equal volume of 0.9%saline were infused in control group.Anesthesia was induced with propofol and sufentanyl, then maintained with propofol and remifentanil.MAP,HR,SpO2 were monitored and recorded at the time points of pre-administration,administration completed immediately,immediately pre-intuba-tion,1 min,3 min and 5 min after intubation.Neuromuscular function was monitored using accelero-myography.The onset time and 25%,50%,75%,90%recovery time of rocuronium were recorded. Results The onset time of rocuroniumin dexmedetomidine group is shorter than that in the control group (P<0.05).There is no effect on the 25%,50%,75%,90%recovery time of rocuronium. Conclusion Dexmedetomidine prior to induction can shorten the onset time of rocuronium,but there was no effect on the recovery time of rocuronium.

关 键 词：全凭静脉麻醉 右美托咪定 罗库溴铵 起效时间 恢复时间 

分 类 号：R614.24[医药卫生—麻醉学]