七氟醚、异氟醚对国产顺式阿曲库铵强化作用的时间依赖性研究  

Time course of potentiation of cisatrarium by desflurane versus isoflurane

作　　者：杨在启[1] 魏丕红[1] 马桂芬[1] 

机构地区：[1]泰山医学院附属泰安医院,山东泰安271000

出　　处：《泰山医学院学报》2008年第11期882-884,共3页Journal of Taishan Medical College

摘　　要：目的观察1MAC七氟醚或异氟醚对国产顺式阿曲库铵强化作用的时间依赖性。方法30例择期头面部手术病人在咪唑安定—芬太尼—异丙酚麻醉期间持续输注国产顺式阿曲库铵,维持95%的肌松,达到稳态后,病人随机吸入呼气末浓度为1MAC的七氟醚或异氟醚,调整顺式阿曲库铵的注入速率,维持95%的肌松,观察吸入七氟醚或异氟醚后顺式阿曲库铵的注人速率随时间变化的趋势。结果七氟醚、异氟醚都显著降低了顺式阿曲库铵的注入速率,此效应随吸人七氟醚或异氟醚时间的延长逐渐增加,吸入七氟醚或异氟醚90min后达最大效应即顺式阿曲库铵的注人速率下降到最大值。最大下降率:七氟醚组为39.7%,异氟醚组为36.4%。结论七氟醚、异氟醚明显增强顺式阿曲库铵的肌松作用,其程度相近,且这种强化作用有显著的时间依赖性。Objective ： To investigate the time course of potentiation of cisatrafium produced by 1 MAC of sevoflurane or isoflurane. Methods： Thirty ASA Ⅰ-Ⅱ patients aged 18 -60 years undergoing elective operation under general anesthesia were studied. Patients should have no neuromuscular, liver or kidney disease, and didnt receive any drug which might affect neuromuscular transmission. Anesthesia was induced with midazolam 0.1 - 0.2 mg · kg^ -1, fentanyl 4 μg · kg^ -1 and etomidate 0.3 mg · kg^ -1. Tracheal intubation was facilitated with cisatrarium 0.3 mg · kg^ -1 iv. The degree of neuromuscular block was monitored by using train - of - four （TOF） stimulation ulnar nerve. For maintenance of anesthesia, the patients were randomly assigned to receive either propofol ＋ fentanyl （control group） orl MAC of sevoflurane ＋ propofol ＋ fentanyl （sevoflurane group） or 1MAC of isoflurane ＋ propofol ＋ fentanyl （isoflurane group）. Cisatrarium was continuously infused during operation to maintain T1 at 5% of the control and the infusion rate was recorded every 15 rain. Results： There were no significant differences among the three groups with respect to sex, age, body weight and duration of anesthesia. In Sevo and Iso groups the infusion rate of cisatrarium was reduced in an exponential manner and maximal potentiation occurred at 90 min of isoflurane or sevoflurane inhalation. The maximal reduction in infusion rate was 39.7% in Sevo group and 37.8% in Iso group. There was no significant difference between the two groups. Conclusion： Sevoflurane and isoflurane can potentiate the muscle relaxation produced by cisatrarium in a similar degree and the potentiation is time dependent.

关 键 词：七氟醚 异氟醚 顺式阿曲库铵 神经肌肉接头 药物相互作用 

分 类 号：R614[医药卫生—麻醉学]