高渗氯化钠羟乙基淀粉40注射液对顺式阿曲库铵肌松效应的影响  

Influence of hypertonic sodium chloride hydroxylethyl starch 40 injection on muscle relaxation effect of cisatracurium

作　　者：赵雪莲[1] 安广权[2] 高雁[1] 马洪亮[1] 史建稳[1] 宋子贤[1] 

机构地区：[1]河北医科大学第四医院麻醉科,石家庄050011 [2]河北医科大学第四医院外二科,石家庄050011

出　　处：《上海医学》2010年第10期893-896,共4页Shanghai Medical Journal

摘　　要：目的观察高渗氯化钠羟乙基淀粉40注射液(HSS40)对非去极化肌肉松弛药顺式阿曲库铵肌松效应的影响。方法 60例患者按输注液体种类及是否应用新斯的明拮抗肌松随机分为4组,即应用HSS40不用新斯的明的HR组和用新斯的明的HC组,应用羟乙基淀粉130/0.4氯化钠注射液(HES130/0.4)不用新斯的明的WR组和用新斯的明的WC组。麻醉诱导为靶控输注丙泊酚和瑞芬太尼,患者入睡后静脉注射顺式阿曲库铵(0.15mg/kg)并行气管插管。术中追加顺式阿曲库铵剂量为每次0.05mg/kg。应用加速度仪进行尺神经刺激监测肌松情况。记录肌肉松弛药的起效时间、维持时间及恢复指数。结果各组间顺式阿曲库铵起效时间的差异均无统计学意义(P值均>0.05)。HR组和HC组首次注射和追加的顺式阿曲库铵肌松时效均分别显著短于WR组和WC组(P值均<0.05)。HR组和WR组恢复指数的差异无统计学意义(P>0.05),HC组的拮抗恢复指数显著大于WC组(P<0.05)。结论应用HSS40可缩短顺式阿曲库铵的肌松时效,但延缓新斯的明拮抗后的肌松恢复。Objective To investigate the influence of hypertonic sodium chloride hydroxylethyl starch 40（HSS40）infusion on the non-depolarizing muscle relaxation effect of cisatracurium.Methods Sixty patients were randomly divided into four groups：the HR group only received HSS40 infusion without neostigmine,the HC group received HSS40 with the muscle relaxation of cisatracurium reversed with neostigmine postoperatively,the WR group received hydroxide ethylic starch130/0.4（HES130/0.4）infusion without neostigmine,and the WC group received HES130/0.4 with the muscle relaxation reversed with neostigmine.Tracheal intubation was induced by infusing propofol and remifentanyl through target-controlled infusions and injecting cisatracurium（0.15 mg/kg）as the patients falling asleep.Muscle relaxation was maintained with bolus injection of cisatracurium（0.05 mg/kg）.The relaxation of adductor pollicis muscle were monitored with train-of-four（TOF）-Watch SX following supramaximal electric stimulation of the ulnar nerve.The onset time of cisatracurium,duration of action,recovery index（time of T1 from 25% to 75%）were recorded.Results There was no significant difference in onset time of cisatracium among the four groups（all P0.05）.The duration of induction action and maintenance doses of cisatracurium were significantly shorter in the two HSS40 infusion groups than those in HES130/0.4 infusion groups（all P0.05）.The recovery index of cisatracurium was not significantly different between the HR group and WR group（P0.05）.However,the recovery index in HC group was longer than that in the WC group after administration of neostigmine（P0.05）.Conclusion Hypertonic sodium chloride hydroxylethyl starch 40 injection can reduce the action duration of cisatracurium and prolong the recovery time of cisatracurium antagonized with neostigmine.

关 键 词：高渗氯化钠 羟乙基淀粉 顺式阿曲库铵 

分 类 号：R614[医药卫生—麻醉学]