急性高容性血液稀释对顺式阿曲库铵药效学的影响  

Effects of acute hipervolemic hemodilution on pharmacodynamics of cisatracurium

作　　者：魏淑明[1] 

机构地区：[1]泰山医学院附属泰山医院麻醉科,山东泰安271000

出　　处：《泰山医学院学报》2012年第1期34-37,共4页Journal of Taishan Medical College

摘　　要：目的探讨术前急性高容性血液稀释(AHHD)对顺式阿曲库铵药物效应学的影响以及AHHD中维持90～99%肌松所需静脉泵注速度,为血液稀释下合理应用该药提供参考资料。方法全麻择期手术患者26例,ASA分级Ⅰ～Ⅱ。无神经肌肉疾患,所用术前用药对肌松药物无影响。对13例预计术中出血大于600ml的患者,于术前施AHHD(Ⅰ组)。另13例预计术中出血小于200ml的患者作为对照组(Ⅱ组)。血液稀释组ADDH平稳10min后给予顺苯磺酸阿曲库铵0.15mg.kg-1。对照组不实施任何血液稀释技术以及血液保护措施。于气管插管监测指标平稳后给予顺苯磺酸阿曲库铵0.15mg.kg-1。记录起效时间以及T1恢复至25%时间(作用时间)。计录维持T1在1～10%所用顺式阿曲库铵剂量,以及各项恢复参数。结果静脉注射CIS0.15mg.kg-1,起效时间AHHD组为3.3±1.1min对照组为4.2±1.4 min(P<0.05)。作用时间分别是52.2±7.6 min、53.4±6.2 min(P>0.05),维持T11-10%所需顺式阿曲库铵的输注速度分别为0.9±0.3 ug.kg-1.min-1、1±0.1 ug.kg-1.min-1(P>0.05)。恢复指数分别为14.3±2.4min、13.9±2.9min(P>0.05)。结论 AHHD可增快顺式阿曲库铵起效时间,对恢复时相及维持90～99%肌松所需的输注速度则无影响。Objective： To investigate the pharmacodynamics of cisatracurium under acute hypervolemic hemodilution and to find the intravenous infusion rate required to maintain 99～100% muscle relaxation,and to provide a reasonable clinical reference.Methods： Twenty-six patients undergoing elective radical gastrectomy under general anesthesia without any neuromuscular disease were divided into two groups.Thirteen patients to be estimated more than 600ml of blood loss recieved AHHD（group,n=13）,and the others with no hemolution as control（group Ⅱ,n=13）.CIS（0.15 mg/kg） was intravenously infused for GroupⅠafter AHHD stabilized for 10 minutes.For GroupⅡ,cisatracurium was intravenously infused after the trachea was intubated.The onset time（T1100～0%） and clinical duration（T10～25%） were recorded.We recorded the time from the onset to T1 recovery of 25% and the amount of cisatracurium administered per minute to maintain T1 for 1～10%,and the rerovery index.Results： The onset time of cisatracuriun in the two groups were 3.3±1.1min.and 4.2±1.4 min.（P0.05）.The infusion rates of cisatracurium in the two groups were 1±0.1 ug.kg-1.min-1and0.9±0.3 ug.kg-1.min-1（P0.05）.Recovery index in two groups were 14.3±2.4min.and 13.9±2.9min（P0.05）.Conclusion： It is suggested that AHHD can shorten the onset time of cisatracurium but it is not significant to recovery index and the intravenous infusion rata.

关 键 词：急性高容性血液稀释 顺式阿曲库铵 药物效应动力学 

分 类 号：R614[医药卫生—麻醉学]