罗库溴铵、维库溴铵和阿曲库铵用于全麻气管插管肌松效应的对比研究  

Comparison of neuromuscular blockade effects of rocuronium,vecuronium and atracurium on rapid endotracheal intubation

作　　者：杜金满[1] 郭建荣[1] 任利远[1] 

机构地区：[1]宁波大学医学院附属李惠利医院麻醉科,宁波315040

出　　处：《实用药物与临床》2006年第4期222-224,共3页Practical Pharmacy and Clinical Remedies

摘　　要：目的观察比较罗库溴铵、维库溴铵及阿曲库铵在全麻诱导气管插管时的肌松效应及不良反应。方法ASAⅠ～Ⅱ级择期全麻下行腹腔镜胆囊切除手术患者120例，随机分为：罗库溴铵组（Ⅰ组）、维库溴铵组（Ⅱ组）、阿曲库铵组（Ⅲ组），每组给2倍ED95剂量肌松剂。Ⅰ组按用量再分为：Ⅰa组（2倍ED95，0．6mg／kg）、Ⅰb组（3倍ED95，0．9mg／kg）2个亚组。每组各30例。麻醉诱导依次静注咪达唑仑0．06mg／kg、芬太尼4μg／kg，异丙酚2mg／kg后，Ⅰa、Ⅰb组分别静注罗库溴铵0．6mg／kg、罗库溴铵0．9mg／kg，Ⅱ组静注维库溴铵0．15mg／k，Ⅲ组静注阿曲库铵0．5mg／kg。观察各组气管插管时的肌松效果及不良反应。结果Ⅰ组的起效时间及插管状态优良率均明显高于Ⅱ、Ⅲ组，Ⅰb组的插管条件好于Ⅰa组。Ⅰ组的支气管痉挛、皮疹等不良反应的发生率明显低于其他组，对循环系统的影响也较小。结论罗库溴铵比维库溴铵、阿曲库铵起效快，恢复迅速。不良反应少．是较好的全麻气管插管肌松药。Objective To compare the neuromuscular blockade effect and side effect of rocuronium, vecuronium and atracurium on rapid endotracheal intubation. Methods One hundred and twenty patients were randomized to four groups （ n = 30） ： Ⅰ a group （rocuronium, 0.6 mg/kg）, Ⅰ b group （rocuronium, 0.9 mg/kg）, Ⅱ group （vecuronium, 0.1 mg/kg）, m group （atracurium, 0.5 mg,/kg）. All patients were anesthetized with intravenously injection of midazolam （0.06 mg/kg）, fentanyl （4 μg/kg）, propofol （2 mg/kg） and muscular relaxants. Then the neuromuscular blockade and side effects of groups were observed. Results The onset and recovery time of Ⅰ group were shorter than other groups significantly. The intubation situation of Ⅰ group was better, and the side effects were less than Ⅱ and Ⅲ groups. Conclusion Compared with vecuronium and atracurium, rocuronium is quick in onset and recovery, and has little side effect. It is a good relaxant for rapid endotracheal intubation.

关 键 词：罗库溴铵 维库溴铵 阿曲库铵 气管插管 肌松效应 

分 类 号：R614.24[医药卫生—麻醉学] R917.2[医药卫生—外科学]