不同剂量氯胺酮复合顺式阿曲库铵预注对肌松效应的影响  

The effect of different dose of ketamine and priming of cisatracurium on muscle relaxant effect

作　　者：李明惠[1] 苏靖诚[1] 潘露菲[1] 周泽军[1] 谭宪湖[1] 

机构地区：[1]广西医科大学第一附属医院麻醉科,广西南宁530021

出　　处：《蛇志》2014年第1期32-33,71,共3页Journal of Snake

摘　　要：目的比较顺式阿曲库铵预注、不同剂量氯胺酮复合顺式阿曲库铵预注对顺式阿曲库铵起效时间、血流动力学的影响。方法选择全麻下行择期手术的患者120例随机分成4组,即Ⅰ(生理盐水0.5ml)组、Ⅱ(顺式阿曲库铵0.01mg/kg)组、Ⅲ(顺式阿曲库铵0.01mg/kg预注复合氯胺酮0.5mg/kg)组、Ⅳ(顺式阿曲库铵0.01mg/kg预注复合氯胺酮1mg/kg)组,预注、预处理3min后,Ⅰ组静注插管剂量顺式阿曲库铵0.15mg/kg,Ⅱ、Ⅲ、Ⅳ组静注剩余插管剂量顺式阿曲库铵0.14mg/kg。使用四个成串刺激(TOF),待T1达最大抑制程度时行气管插管,记录肌松起效时间,同时观察HR、BP的变化。结果Ⅱ、Ⅲ、Ⅳ组肌松起效时间明显短于Ⅰ组(P<0.05),且Ⅲ、Ⅳ组起效时间较Ⅱ组短(P<0.05),但Ⅲ、Ⅳ组起效时间比较无统计学意义(P>0.05);各组麻醉诱导期间均无明显心血管不良反应。结论氯胺酮0.5mg/kg复合顺式阿曲库铵0.01mg/kg、氯胺酮1mg/kg复合顺式阿曲库铵0.01mg/kg均能进一步缩短肌松起效时间,且无明显心血管不良反应。Objective To investigate the effect of different low dose ketamine and cisatracurium priming on hemo- dynanics and onset time of cisatracurium. Methods 120 consecutive patients undergoing general anesthesia were randomly assigned to one of 4 groups. All patients were injected one of normal saline （group Ⅰ）, cisatracurium 0. 01 mg/kg （group Ⅱ） ,combination of cisatracurium 0.01 mg/kg,and ketamine 0.5 mg/kg （group Ⅲ） and com- bination of cisatracurium 0.01 mg/kg,and ketamine 1 mg/kg （group Ⅳ） diluted into a 5 ml solution, followed 3 minutes later by cisatracurium 0.15 mg/kg in group Ⅰ,and 0.14 mg/kg cisatracurium in group Ⅱ , Ⅲ , Ⅳ. Onset time was recorded the electromyographical responses using single twitch and intubating conditions were evaluated at 60 seconds after cisatracurium administration. Results The mean onset time.was most significantly acceler- ated in Group Ⅲ, Ⅳ and was also significantly more accelerated in Group Ⅱ, Ⅲ and IV compared with Group Ⅰ（P〈0.05）. Conclusion The combination of the low dose ketamine 0. 5,1.0 mg/kg and cisatracurium priming 0.01 mg/kg accelerated the onset time.

关 键 词：顺式阿曲库铵 氯胺酮 肌松起效时间 血流动力学 

分 类 号：R719.8[医药卫生—妇产科学] R614[医药卫生—临床医学]