新斯的明拮抗维库溴铵作用的剂量与时机  

Optimum Dose and Time of Neostigmine against Vecuronium-induced Neuromuscular Blockade

作　　者：钱建华[1] 韩冬梅 林洪启[1] 

机构地区：[1]河南省人民医院麻醉科,郑州市450003 [2]山东省临沂市高新区人民医院麻醉科,临沂市276017

出　　处：《医药论坛杂志》2005年第15期21-22,24,共3页Journal of Medical Forum

摘　　要：目的探讨新斯的明拮抗维库溴铵的剂量与时机。方法60例患者随机分成3组(各20例),各组均连续输注维库溴铵,术毕前5min停止输注维库溴铵,周围神经刺激不能引起反应时A组先予静脉推注新斯的明0.015mg/kg+阿托品0.15mg,待T1恢复至10%时静脉推注新斯的明0.035mg/kg+阿托品0.25mg;B组即时静脉推注新斯的明0.035mg/kg+阿托品0.25mg;C组待T1自然恢复至10%时静脉推注新斯的明0.035mg/kg+阿托品0.25mg;记录从停止输注维库溴铵至T1恢复至90%、TOF恢复至70%和90%的时间;术毕15min时T1、TOF比值。结果A组T1恢复至90%、TOF恢复至70%和90%的时间较B、C组缩短(P<0.01,P<0.05);术毕15min时T1、TOF比值A组较B、C组高(P<0.01)。结论应用新斯的明的剂量与时机影响维库溴铵肌松作用的拮抗。Objective To evaluate the optimum dose and time of neostigmine against vecuronium-induced neuromuscular blockade. Methods Neostigmine was administrated while neuromuscular transmission was blocked and no activity of peripheral nerves could be induced by using a continuous infusion of vecuronium, 60 patient were randomized into 3 groups, with 20 patient in each group. Group A received neostigmine 0.015mg/kg and atropine 0.15mg, in advance and when T1 value recovered to 10%, neostigmine 0.035mg/kg and atropine 0.25mg, Group B received neostigmine 0.035mg/kg and atropine 0.25mg, when T1 va lues had recovered to 10%. We recorded the time from the ceasion of vecuronium infusion to the recovery of T1 to 90%. TOF to 70% and 90%, and T1 value and TOF ratio at 15 minutes after operation. Results Recovery of T1 to 90%, TOF to 70% and 90% in group A were faster than those in group B、C（P〈0.01, P 〈0.05, respectively）, T1 value and TOF ratio in group A at 15 minutes after operation were also higher than those in other two groups（P〈0.01）. Conclusion Dose and time of neuromuscular administration can affect the anatgonism effect to vecuronium- induced neuromuscular blockade.

关 键 词：维库溴铵 新斯的明 神经肌肉阻滞 

分 类 号：R971.2[医药卫生—药品]