不同静脉麻醉深度对罗库溴铵药效学的影响  

Effect of depth of intravenous anesthesia on neuromuscular blockage induced by rocuronium

作　　者：丁英[1] 李小葵[1] 李天佐[1] 

机构地区：[1]首都医科大学附属北京同仁医院麻醉科,100730

出　　处：《北京医学》2012年第8期683-685,共3页Beijing Medical Journal

基　　金：北京医药产品和技术重大项目培育研究(Z101107050210030)

摘　　要：目的研究不同静脉麻醉深度对罗库溴铵肌松作用时效的影响。方法择期耳鼻喉科手术患者40例,ASAⅠ～Ⅱ级,随机分为控制性降压组(H组)和对照组(C组),每组20例。麻醉诱导采用咪唑安定、丙泊酚、瑞芬太尼静脉注射,意识消失后启动神经刺激器,静脉注射罗库溴铵后行气管内插管。术中丙泊酚及瑞芬太尼维持麻醉。诱导后10min,H组患者加深麻醉将血压(平均动脉压)降至55～70mmHg。采用4个成串刺激(TOF)模式,记录临床维持时间、75%恢复时间和恢复指数。结果两组临床维持时间差异无统计学意义[(32.50±5.94)minvs.(30.70±5.96)min,P=0.345],而H组的75%恢复时间和恢复指数[(48.70±8.47)minvs.(42.25±6.32)min,(16.20±5.54vs.11.45±4.77),P﹤0.05]均显著长于C组。结论加深静脉麻醉深度实施控制性降压可以强化罗库溴铵的肌肉松驰作用。Objective To study the effect of depth of intravenous anesthesia on neuromuscular blockage induced by rocuronium. Methods Forty ASAⅠ～Ⅱpatients scheduled for elective ENT surgery were studied. They were random- ly assigned to one of the two groups （n=20 each）： hypotension group （group H） and the control group （group C）. All patients were anesthesized with midazolam, propofol and remifentanil. Tracheal intubation was performed after consciouslessness and rocuronium injection. Anesthesia was maintained with propofol and remifentanil. Ten minutes after induction, MAP of group H was controlled between 55 to 70 mm Hg. TOF stimulation was used. The onset time, clinical duration and 75% re- covery time and recovery index were recorded. Results There was no significant difference in clinical duration between the two groups, and 75% recovery time and recovery index were significantly higher in group H than in group C. Conclu- sion The effect of neuromuscular block by roeuronium could be enhanced by deeper intravenous anesthesia.

关 键 词：罗库溴铵 静脉麻醉 控制性降压 4个成串刺激 

分 类 号：R614[医药卫生—麻醉学]