七氟醚对老年人顺式阿曲库铵肌松效应的影响  

The effect of sevoflurane-remifentanil on neuromuscular blocking effect of cisatracurium in elderly

作　　者：曾兆东[1] 程明华[1] 庄少惠[1] 林树勇[1] 

机构地区：[1]汕头大学医学院第一附属医院麻醉科,广东省汕头市515041

出　　处：《中华全科医学》2014年第2期192-193,共2页Chinese Journal of General Practice

基　　金：广东省医学科研基金立项课题(A2011393)

摘　　要：目的比较七氟醚复合瑞芬太尼靶控对于老年人顺式阿曲库铵肌松效应的影响。方法40例行择期手术的患者，ASAⅠ～Ⅱ级，按年龄分为老年组（≥65岁）和青年组（18岁〈年龄〈65岁）。麻醉诱导使用七氟醚、异丙酚、瑞芬太尼，麻醉诱导后所有患者经上肢静脉注0．15mg／kg顺式阿曲库铵。用TOFWATCH加速度仪进行肌松监测，采用4个成串刺激（TOF，频率2Hz，波宽0．2ms，串问间隔15S）。肌肉松弛效应观察指标包括：起效时间，T1恢复到25％、75％的时间，以及TOFr恢复至0．9的时间和恢复指数（T1恢复25％～75％的时间）。结果顺式阿曲库铵起效时间、恢复指数2组问差异无统计学意义（P〉0．05）；T1 25％、T175％、TOFr（T4／T1）恢复至0．9的时间2组问差异无统计学意义（P〉0．05）。结论在老年患者静吸复合全麻中顺式阿曲库铵肌松效果好、停药后肌松恢复较快，增龄对单次静脉注射顺式阿曲库铵的药效学无明显影响。Objective This study was designed to compare the effect of sevoflurane and remifentanil on neuromuscular blocking effect of cisatracurium in elderly and adult. Methods 40 patients, ASA Ⅰ - Ⅱ, undergoing elective surgery, were randomly divided into elderly and adult groups. Anesthesia was induced with sevoflurane 8% using a vital capacity breath technique, ＇after BIS value aeheieved 60, remitentanil 2 - 4 ng/ml was given, cisatraeurium O. 15 mg/kg were admin- istered after induction. Anaesthesia was maintained with end-tidal concentrations 1.0 MAC and remifentanil （2 ug/ml）. Cumulative dose-effect curves for cisatracurium were determined during anaesthesia with 1.73% sevoflurane. Neuromus- cular block was assessed by aeceleromyography（TOF-Watch） after train-of-four（TOF） stimulation of the ulnar nerve. Results There was no significant difference between the two groups （P 〉 0.05）. And The duration of recovery to 25% , 75% of T1 （TI 25%, T1 75% ）, TOF rate of O. 9, recovery index（RI） was no significantly different between the two groups （ P 〉 0. 05 ）. Conclusion Aging had no influence on the pharmacodynamies of single injection of cisatracurium.

关 键 词：顺式阿曲库铵 七氟烷 老年人 

分 类 号：R614[医药卫生—麻醉学] R971.8[医药卫生—外科学]