靶控输注维库溴铵在口腔颌面手术的应用  

Application of vecuronium TCI in oral and maxillofacial surgery

作　　者：孙强[1] 俞燕[1] 

机构地区：[1]南京医科大学附属口腔医院麻醉科,210029

出　　处：《江苏医药》2010年第5期521-522,共2页Jiangsu Medical Journal

摘　　要：目的探讨靶控输注(TCI)维库溴胺在口腔颌面外科手术中的应用。方法择期手术患者60例,随机分为维库溴铵靶控输注(TCI)(Ⅰ组)和常速输注(Ⅱ组),每组30例。静脉推注咪唑安定、芬太尼、丙泊酚后,Ⅰ组维库溴铵起始血浆靶控浓度0.14μg/ml;Ⅱ组0.1 mg/kg静脉推注维库溴铵。气管插管后,Ⅰ组维库溴铵继续TCI输注,调整靶浓度每次增加0.01μg/ml,直至T1消失。Ⅱ组50μg.kg-1.h-1静脉持续泵入,调整泵速至T1消失。临近手术结束时停用维库溴铵,术毕不用肌松拮抗药。记录肌松起效时间、维库溴铵用量和肌张力恢复时间。结果Ⅰ组肌松起效时间(291.07±28.48)s,显著长于Ⅱ组的(244.87±26.03)s(P<0.01);Ⅰ组维库溴铵平均用药量(57.47±4.77)μg.kg-1.h-1,明显少于Ⅱ组的(80.30±8.08)μg.kg-1.h-1(P<0.01);Ⅰ组肌张力恢复时间(16.85±1.94)min,明显短于Ⅱ组的(21.00±1.48)min(P<0.01)。结论与常速输注方法比较,维库溴铵TCI能减少药物用量,利于肌张力恢复,更适用于长时间手术。Objective To observe the application of vecuronium target-controlled infusion（TCI） in oral and maxillofacial surgery.Methods Sixty patients were randomly divided into 2 groups of vecuronium TCI （groupⅠ） and conventional vecuronium infusion（group II） with 30 cases each.After midazolam,fentanyl and propofol injection,an initial plasma TCI concentration of vecuronium in group Ⅰ was 0.14 μg/ml.A bolus dose of vecuronium in group Ⅱ was 0.1 mg/kg,which was followed by vecuronium 50 μg·kg-1·h-1 infuson.The infusion speed was adjusted to keep T1 disappeared for both groups.Vecuronium infusion was stopped at the end of operation and no antagonist was used for antagonizing vencuronium in both groups.The onset time and average dose used during operation,and the recovery time of muscular tension were recorded.Results The onset time of vencuronium was longer in group Ⅰthan that in group Ⅱ [（291.07±28.48） s vs.（244.87±26.03） s]（P0.01）.The recovery time of muscular tension was shorter in group Ⅰthan that in group Ⅱ [（16.85±1.94） min vs.（21.00±1.48） min]（P0.01）.The average dose of vecurinium was less in group Ⅰthan that in group Ⅱ [（57.47±4.77） μg·kg-1·h-1 vs.（80.30±8.08） μg·kg-1·h-1]（P0.01）.ConclusionCompared to conventional infusion,vecuronium TCI saves the drug,gets quicker recovery and is suitable for operations lasting for a long time.

关 键 词：维库溴胺 靶控输注 

分 类 号：R614[医药卫生—麻醉学]