七氟烷与丙泊酚同等麻醉对老年患者顺式阿曲库铵肌松效应的影响  

Effect of propofol or sevoflurane on the quality of neuromuscular blockade with cisatracurium duringcomparable depth of anesthesia in elderly patients

作　　者：邵军进[1] 吕蕾[1] 任祖华[1] 吕金英[1] 

机构地区：[1]浙江省东阳市人民医院暨温州医学院附属东阳医院麻醉科,321000

出　　处：《中华老年医学杂志》2013年第6期659-661,共3页Chinese Journal of Geriatrics

基　　金：浙江省医学会临床科研项目（2011ZYC-A101）

摘　　要：目的比较七氟烷与丙泊酚在同等麻醉深度时对老年患者顺式阿曲库铵肌松效应的影响。方法选择70例美国麻醉师协会（AsA）Ⅰ-Ⅱ级的60周岁以上老年患者，随机分为丙泊酚组和七氟烷组两组，每组35例。采用电刺激尺神经监测拇内收肌肌颤搐反应的方法进行肌松监测。两组分别采用丙泊酚和七氟烷进行麻醉诱导并比较两组顺式阿曲库铵在不同时间点注入速率和患者意识消失时间与顺式阿曲库铵肌松起效时间。结果吸人七氟烷后检测各时间点顺式阿曲库铵的注入速率，与未吸人前（即0rain）相比，分别下降了11．19％、29．82％、42．28％、37．15％。七氟烷组的注入速率在60min之后下降较高，与丙泊酚组相比差异有统计学意义（P〈O．05）。两组患者意识消失时间分别为（54．47±10．55）S和（53．89±11．48）S，差异无统计学意义（P〉0．05）；而顺式阿曲库铵肌松起效时间分别为（148．62±28．54）S和（96．53±23．69）S，七氟烷组起效时间短于丙泊酚组（P〈0．05）。结论与丙泊酚比较，七氟烷能明显缩短顺式阿曲库铵的起效时间并延长顺式阿曲库铵的延长时效。Objective To investigate the effect of propofol or sevoflurane on the quality of neuromuscular blockade with cisatracurium during comparable depth of anesthesia in elderly patients. Methods A total of 60 patients aged over 60 years [classified as American Society of Anesthesiologists （ASA） physical status Ⅰ-Ⅱ ] were selected. Patients were randomized into 2 groups： propofol group （induction of anesthesia with propofol） and sevoflurane group （induction of anesthesia with sevoflurane） （n= 35, each）. Neuromuscular blocking effect was monitored by muscle response to ulnar nerve stimulation. The rates of cisatracurium injection at different time points, time of loss of consciousness and the onset time of cisatracurium neuromuscular block were compared between the two groups. Results The rate of cisatracurium injection was significantly decreased at 60 minutes, 90 min, 120 min in sevoflurane group（29.82% ,42.285 ,37.15%）, and the onset time of cisatracurium neuromuscular block was significantly shorter in sevoflurane group than in propofol group （（148.62±28.54）svs （96.53±23.69）s ,P〈0.05]. Conclusions Compared withpropofol, sevoflurane can greatly shorten the onset time of cisatracurium and enhance the effect of cisatracurium neuromuscular block with stable hemodynamics.

关 键 词：二异丙酚 肌松弛药 中枢性 麻醉药 吸入 

分 类 号：R614[医药卫生—麻醉学]