罗库溴胺用于重症肌无力患者胸腺切除术的肌松效应  

Neuromuscular pharmacodynamics of rocumnium bromide in thymectomy of myasthenia gravis patients

作　　者：秦雪梅[1] 鲁卫华[1] 金孝岠[1] 姚卫东[1] 唐宁[1] 

机构地区：[1]皖南医学院附属弋矶山医院麻醉科

出　　处：《中国临床药理学与治疗学》2012年第11期1263-1267,共5页Chinese Journal of Clinical Pharmacology and Therapeutics

基　　金：安徽省卫生厅医学科研项目(2010C066)

摘　　要：目的:探讨罗库溴铵在重症肌无力(MG)患者胸腺切除术中的肌松效应。方法:选择本院择期拟行胸腺切除术Ⅰ～Ⅱa型MG患者23例为试验组,20例正常非MG患者为对照组,均采用气管插管全凭静脉麻醉,给予罗库溴铵0.6mg/kg诱导,术中使用肌松监测仪记录罗库溴铵神经肌肉阻滞效应,及应用多功能监测仪进行心率变异性分析。结果:所有患者麻醉平稳,手术顺利,未见不良反应发生。两组患者各时点平均动脉压(MAP)、HR、心率变异性(HRV)、低频/高频比(LF/HF)差异无统计学意义。试验组肌松起效时间短于对照组,两组之间差异有统计学意义(P<0.05)。两组肌松T125%恢复时间、T150%恢复时间、恢复指数差异均无统计学意义。结论:对Ⅰ～Ⅱa型MG患者使用0.6mg/kg罗库溴铵进行快速诱导行气管插管,肌松起效时间短,维持时间影响小,且不良反应少,可为气管插管提供良好的肌松条件,安全有效地用于MG患者。AIM： To investigate the neuro- muscular pharmacodynamics of rocuronium on thymectomy in myasthenia gravis （MG） pa tients. METHODS： Twenty-three Ⅰ-Ⅱ a MG patients undergoing elective thymectomy （Group M） since January 2006 were studied. Another twenty non-MG patients undergoing other elec tive surgery were included as control group （Group C）. All patients were performed under total intravenous anesthesia by tracheal intuba- tion, given a loading dose of rocuronium 0.6 mg/kg as anesthesia induction. Neuromuscular transmission was monitored by measuring the twitch tension of the adductor pollicis muscle. And the heart rate variability （HRV） was ana- lyzed during the surgery. RESULTS：Anesthesia and surgery were carried out successfully with- out any adverse reaction. The analysis revealed that the MAP, HR, HRV, LF/HF had no sig- nificant difference between the two groups at alltime points. The onset time was significantly shorter in group M than that in the group C （P 〈0.05）. There were no significant group differ ences in the recovery time of T1 to 25%, the re covery time of T1 to 50%, and the recovery indi- ces （interval, 25% - 75%）. CONCLUSION： The results show that rocuronium, as anesthesia induction at a dose of 0.6 mg/kg, has a shorter muscle relaxants onset time and a small influence on the maintaining time. It also can result in fe wer perioperative complications and provide op- timal operating conditions. It is a safe anaesthesi- a method in thymectomy of Ossermen Ⅰ-Ⅱ a MG patients with anesthesia induction by injec ting rocuronium.

关 键 词：雄甾烷醇类 重症肌无力 神经肌肉阻滞 心率变异性 

分 类 号：R614[医药卫生—麻醉学]