七氟醚吸入维持下维库溴铵对反应熵的影响  

Effect of vecuronium on the response entropy under sevflurane anaesthesia

作　　者：荆凤娥[1] 秦向阳 崔修德[1] 徐志新[3] 

机构地区：[1]焦作市第二人民医院麻醉科,河南焦作454000 [2]焦作市第五人民医院普外科,河南焦作454000 [3]新疆医科大学第一附属医院麻醉科,乌鲁木齐830000

出　　处：《中华实用诊断与治疗杂志》2014年第1期95-96,共2页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的探讨在全身麻醉维持期间维库溴铵对反应熵的影响。方法择期行腹腔镜手术患者60例随机分为对照组和观察组各30例,2组均采用全身麻醉,对照组维持期间静脉注射生理盐水2mL,观察组静脉注射生理盐水稀释后的维库溴铵(0.1mg/kg)2mL,4min后给予尺神经强直刺激(频率50Hz,电流80mA,时间0.25ms)。比较2组麻醉后(T1),应用维库溴铵或生理盐水后4min(T2),强直刺激即刻(T3),强直刺激后1min(T4)、3min(T5)、5min(T6)反应熵值。结果 2组T1、T2时间点反应熵值比较差异无统计学意义(P>0.05);2组T3时间点反应熵值增高,T4时间点反应熵值最高,与T1比较差异均有统计学意义(P<0.05);2组T5、T6时间点反应熵值低于T4(P<0.05),观察组T4、T5时间点反应熵值低于对照组(P<0.05),且观察组T6时间点反应熵值与T1时间点比较差异无统计学意义(P>0.05)。结论无伤害性刺激时,维库溴铵对反应熵的影响不明显;存在伤害性刺激时,维库溴铵可抑制反应熵增加的数值。Objective To explore the effect of vecuronium on the response entropy （RE） under general anesthesia. Methods Sixty patients undergoing elective laparoscopic surgery were randomly divided into observation group and control group, with 30 patients in each group. All patients received general anaethesia. During the period of anaesthesia, control group was given normal saline 2 mL and observation group was given vecuronium 2 mL （0. 1 mg/kg）. After 4 minutes, tetanic electrical stimulation of ulnar nerve was served （frequency： 50 Hz, current： 80 mA, time： 0.25 ms）. The RE data were recorded and compared after anaesthesia （T1）, 4 minutes after injection of normal saline or vecuronium （T2）, when tetanic stimulation （T3）, and 1 minute （T4）, 3 minutes （T5） and 5 minutes （T6） after stimulation. Results RE showed no significant difference at T1 and T2 between two groups （P〉0.05）. RE increased at T3 and was the highest at T4 , which showed a significant difference compared with T1 （P〈O. 05）. RE was lower at T5 and T6 than that at T4 （P 〈0. 05）. RE was lower at T4 and T5 in observation group than that in control group （P〈0. 05）. There was no significant difference between the time point of T6 and T1 in observation group （P〉0.05）. Conclusions Vecuronium has no obvious effect on RE when nociceptive stimulus does not happen, and can inhibit the increase of RE value under nociceptive stimulus.

关 键 词：麻醉深度 维库溴铵 强直刺激 反应熵 

分 类 号：R614[医药卫生—麻醉学]