七氟烷对罗库溴铵、维库溴铵及阿曲库铵临床药效的影响  

Clinical effects of sevoflurane and propofol on the rocuronium, vecuronium and atricunium-induced neuromuscu lar blockade

作　　者：夏会敏[1] 姚尚龙[1] 张诗海[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院麻醉科,武汉430022

出　　处：《国际麻醉学与复苏杂志》2008年第3期201-204,共4页International Journal of Anesthesiology and Resuscitation

摘　　要：目的以丙泊酚为对照，观察1．3MAC的七氟烷对罗库溴铵、维库溴铵及阿曲库铵临床药效的影响。方法选择60例择期腹部手术的病人随机分为6组，每组10人。七氟烷罗库溴铵组（SR组）、七氟烷维库溴铵组（SV组）及七氟烷阿曲库铵组（SA组）分别吸入1．3MAC的七氟烷及静注芬太尼维持麻醉，丙泊酚罗库溴铵组（CR组）、丙泊酚维库溴铵组（CV组）及丙泊酚阿曲库铵组（CA组）以丙泊酚6mg·kg^-1·h^-1～8mg·kg^-1·h^-1及芬太尼维持麻醉。监测起效时间、最大抑制程度、作用时间、维持速率、恢复时间、恢复指数。结果七氟烷组与相应的对照组在最大抑制程度、恢复指数方面的无统计学差异，起效时间、作用时间、维持速率、恢复时间有统计学差异。结论七氟烷能明显延长罗库溴铵、维库溴铵以及阿曲库铵的作用时间和恢复时间并减少其起效时间、维持剂量，但对最大抑制程度和恢复指数则无明显影响。Objective To investigate the effects of 1.3 MAC of sevoflurane on neuromuscular blockade by rocuronium, vecuronium or atracurium,as compared with propofol. Methods Sixty patients （ASA Ⅰ - Ⅱ ） aged 18 -60 years undergoing laparotomy were randomly divided into six groups （n = 10）. In group SR, SV and SA, anesthesisa was maintained at the end - tidal concentration of 1.3 MAC of sevoflurane, with continuous neuromuscular blockade by rocuronium, vecuronium or atracurium respectively; In group CR, CV and CA, only 6 mg ·kg^-1·h^-1 to 8 mg ·kg^-1·h^-1 of propofol was given intravenously to maintain anesthesia, with neuromuscular blockade by rocuronium, vecuronium or atracurium respectively. Accelerometer was employed to detect neuromuscular function with train - of - four stimulation. All patients were given fentanyl intermittently to maintain a relatively stable hemodynamics. Resuits The effectual time, duration, maintenance dose and recovery time of rocuronium, vecuronium and atracurium showed significant difference among these groups （ P 〈 0.05 ）. But there was no significant different between two corresponding groups （ group SR and group CR, group SV and group CV, group SA and group CA ） in maximum inhibition degree and recovery index （ P 〉0.05 ）. Conclusion 1.3 MAC of sevoflurane augmented and prolonged the neuromuscular block produced by rocuronium, vecuronium and atracurium, but not effected their maximum inhibition degree and recovery index.

关 键 词：七氟烷 罗库溴铵 维库溴铵 阿曲库铵 神经肌肉接头 

分 类 号：R614[医药卫生—麻醉学]