七氟醚复合瑞芬太尼对老年患者维库溴铵药效的影响  

Assessment of neuromuscular vecuronium under sevoflurane-remifentanil anesthesia in elderly patients

作　　者：曾兆东[1] 庄少惠[1] 程明华[1] 林树勇[1] 邱忠志[2] 闫威[2] 李恩有[2] 

机构地区：[1]汕头大学医学院第一附属医院麻醉科,515041 [2]哈尔滨医科大学附属第一院麻醉科

出　　处：《临床麻醉学杂志》2013年第6期546-547,共2页Journal of Clinical Anesthesiology

基　　金：广东省科技计划发展项目[(2010)1096]

摘　　要：目的研究七氟醚与瑞芬太尼静-吸复合全麻下老年患者维库溴铵的肌松效应。方法择期行腹腔镜胆囊切除术患者30例,ASAⅠ或Ⅱ级,按年龄分为老年组(65～80岁)和青年组(25～45岁),每组15例。七氟醚和瑞芬太尼诱导后,维持七氟醚呼气末浓度1.0MAC,瑞芬太尼0.05～0.1μg·kg-1·min-1持续输注。维持PETCO2 35～38mmHg。观察T1最大抑制时间(起效时间),T1恢复至25%的时间(T125%)、T1恢复至50%的时间(T150%)、恢复指数(RI)、TOFr(T4/T1)=0.7的时间。结果老年组起效时间、T125%、T150%、RI、TOFr(T4/T1)=0.7的时间均明显长于青年组(P<0.05)。结论老年患者吸入七氟醚全身麻醉中,适当减小维库溴铵的剂量即能达到满意的肌松效果,使患者术后肌力尽早恢复,提高老年患者围术期麻醉安全。Objective To investigate neuromuscular blockade of vecuronium in elderly patients under sevoflurane-remifentanl anesthesia. Methods Thirty ASA I or II patients scheduled for laparoscopy cholecystectomy were randomly derided into group elder （65-80 years） and group youth （25-45 years）. Anesthesia was induced with sevoflurane, remifentanil and vecuroniurru Anesthesia was maintained with 1.0 MAC sevoflurane and remifentanil 0. 05-0.1 μg-kg 1. min 1. Per CO2 was maintained between 35-38 mm Hg. The onset time, T1 25% ,TI 50% recovery index,TOFr 0.7 were assessed. Results The onset time, T1 25%, T1 50%, RI, and TOFr（T4/T1）=0.7 were longer in group elder （P〈0.05）. Conclusion The need of vecuronium is decreased in sevoflurane anesthesia in aged patients, which may be beneficial for the patient＇s safety and recovery.

关 键 词：七氟醚 维库溴铵 瑞芬太尼 老年 

分 类 号：R614[医药卫生—麻醉学]