七氟醚与异氟醚对老年患者持续输注顺式阿曲库铵肌松效应的影响  

Influences of sevoflurane and isoflurane on neuromuscular blockade by continuous infusion of cisatracurium in elderly patients

作　　者：徐钊[1] 郑宏[1] 宣燕[1] 

机构地区：[1]新疆医科大学第一附属医院麻醉科,乌鲁木齐市830054

出　　处：《临床麻醉学杂志》2011年第12期1153-1155,共3页Journal of Clinical Anesthesiology

基　　金：新疆维吾尔自治区科技支疆项目(项目编号:200991126)

摘　　要：目的比较吸入等效浓度七氟醚和异氟醚麻醉下对老年患者持续输注顺式阿曲库铵肌松效应的影响。方法全麻下行耳鼻喉或颌面外科手术老年患者60例,随机均分为三组。七氟醚组(S组)和异氟醚组(I组)分别吸入等效浓度(呼气末浓度1MAC)七氟醚和异氟醚维持麻醉,对照组(C组)靶控输注丙泊酚(血浆靶浓度为2～3μg/ml)维持麻醉,同时三组均持续输注顺式阿曲库铵,使T1稳定在基础值的10%,采用TOF-WatchSX肌松监测仪行拇内收肌肌松监测。记录初始剂量顺式阿曲库铵起效时间、术中输注速率、恢复指数(T1恢复25%至75%)和TOFr恢复至0.9的时间。结果给药30min后各时点S组和I组顺式阿曲库铵输注速率小于C组(P<0.05)。给药45min后各时点I组顺式阿曲库铵输注速率高于S组(P<0.05)。结论等效浓度七氟醚和异氟醚麻醉下均能增强老年患者持续输注顺式阿曲库铵的肌松效应。Objective To compare the effects of sevoflurane and isoflurane on the neuromuscular blockade produced by continuous infusion of cisatracurium in elderly patients. Methods Sixty geriatric patients scheduled for ear-nose-throat surgeries or maxillofacial surgeries under genera[ anesthesia were randomly divided into three groups. Group S and Group I were maintained with inhalation of one minimum alveolar concentration （MAC） of sevoflurane and isoflurane, respectively, while Group C was maintained with target controlled infusion of propofol （target plasma concentration 2 3μg/ml）. Neuromuscular blockade was maintained with continuous cisatracurium infusion in three groups and was monitored using train-of-four （TOF） stimulation by recording the contraction force of adductor pollicis muscle with a TOF-Watch SX monitor to maintain TI, the first twitch in the TOF, at 10% of baseline. The onset time, the infusion rate of cisatracurium, the spontaneous recovery index （T1 25% to 75%）, and the time interval from T1 at 10% of baseline to recovery of TOF ratio of 0. 9 were recorded. Results Thirty minutes after cisatracurium administration, the infusion rate in Group S and Group I was reduced compared with Group C （P〈0.05）. Forty-five minutes after cisatracurium administration, the infusion rate in Group I was greater than that in Group S （P〈 0. 05）. Conclusion Equivalent concentration of either sevoflurane or isoflurane can potentiate the neuromuscular blockade by continuous infusion of cisatracurium in elderly patients.

关 键 词：老年 顺式阿曲库铵 七氟醚 异氟醚 神经肌肉阻滞 

分 类 号：R614[医药卫生—麻醉学]