糖尿病因素对患者顺阿曲库铵肌松效应的影响  

Effect of diabetes mellitus on neuromuscular blocking effect of cisatracurium

作　　者：李金峰[1] 于高起[2] 杨桐伟[3] 

机构地区：[1]中山大学孙逸仙纪念医院麻醉科,广州市510120 [2]吉林大学第一医院麻醉科 [3]吉林大学第二医院麻醉科

出　　处：《中华麻醉学杂志》2011年第6期671-673,共3页Chinese Journal of Anesthesiology

摘　　要：目的评价糖尿病因素对患者顺阿曲库铵肌松效应的影响。方法择期全麻下神经外科手术患者40例，性别不限，年龄30～64岁，体重44～90kg，ASA分级Ⅱ级。根据患者是否合并2型糖尿病分为糖尿病组（D组）和非糖尿病组（ND组），每组20例。患者意识消失后采用EpochxP神经电生理监测仪，以四个成串刺激方法监测神经肌肉传导功能。L稳定在100％时静脉注射顺阿曲库铵0．15mg／kg，肌松起效（T1达到最大抑制程度）后进行气管插管，并行气管插管效果分级，记录顺阿曲库铵起效时间、临床作用时间、恢复时间、恢复指数。结果与ND组比较，D组患者顺阿曲库铵的起效时间延长（P〈0．05），气管插管效果分级、临床作用时间、恢复时间及恢复指数差异无统计学意义（P〉0．05）。结论糖尿病因素可延长患者顺阿曲库铵的起效时间，但对其维持及恢复无明显影响。Objective To investigate the effect of diabetes mellitus on neuromuscular blocking effect of cisatracurium in patients.Methods Forty ASA Ⅱ patients, aged 30-64 yr, weighing 44-90 kg, scheduled for neurosurgical operation under general anesthesia, were assigned into 2 groups （ n = 20 each） ： type 2 diabetes mellitus group （group D） and non-diabetes meUitus group （group ND）. General anesthesia was induced with midazolam, fentanyl and etomidate. Neuromuscular block was assessed with Epoch XP nerve electrophysiology monitor. A train-of-four stimulation of ulnar nerve was used. Cisatracurium 0.15 mg/kg was injected intravenously over 5 s after T1 was maintained at 100% . Tracheal intubation was performed after the onset of the muscle relaxant. Anesthesia was maintained with iv infusion of propofol 4-8 mg· kg^- 1 · h ^- 1 and remifentanil 0.1-0.3 μg· kg^- 1 · h ^- 1. The effect of intubation was evaluated and graded. The onset time, clinical duration, recovery time and recovery index were recorded. Results The onset time was significantly longer in group D than in group ND （ P 〈 0.05）. There was no significant difference in the clinical duration, recovery time and recovery index and intubation effect grade between the two groups （ P 〉 0.05）. Conclusion Diabetes can prolong the onset time of cisatracurium, but has no effect on the clinical duration and recovery time.

关 键 词：糖尿病 阿曲库铵 神经肌肉阻滞 

分 类 号：R614[医药卫生—麻醉学]