糖尿病因素对七氟醚复合麻醉下顺阿曲库铵肌松效应的影响  

Effect of diabetes mellitus on cisatracurium-induced neuromuscular block when combined with sevoflurane anesthesia

作　　者：邢娜[1] 程丹[1] 李治松[1] 常琰子[1] 杜英英[1] 周银辉[1] 弓胜凯[1] 阚全程[2] 张卫[1] 

机构地区：[1]郑州大学第一附属医院麻醉科,450052 [2]郑州大学第一附属医院临床药理基地,450052

出　　处：《中华麻醉学杂志》2014年第5期584-586,共3页Chinese Journal of Anesthesiology

摘　　要：目的 评价糖尿病因素对七氟醚复合麻醉下顺阿曲库铵肌松效应的影响.方法 择期鼻内镜鼻窦手术患者30例,年龄30～60岁,性别不限,BMI 18～ 25 kg/m2,ASA分级Ⅰ或Ⅱ级.DM组：2型糖尿病患者（n=15）,且病程＞3年;C组：非糖尿病患者（n=15）.采用TOF-Watch（R） SX型加速度肌松监测仪监测肌松.麻醉诱导：静脉注射咪达唑仑0.05 ～0.10 mg/kg、芬太尼3～5μg/kg和异丙酚1～2 mg/kg,患者意识消失后启动肌松监测仪TOF模式,随后静脉注射顺阿曲库铵0.15 mg/kg.麻醉维持：吸入七氟醚（呼气末浓度2％）,静脉输注瑞芬太尼0.1 ～ 0.3 μg· kg-1 ＊min-1.记录顺阿曲库铵T1无反应时间、临床作用时间和恢复指数.结果 与C组比较,DM组T1无反应时间、临床作用时间和恢复指数延长（P＜0.05）.结论 糖尿病因素可延长七氟醚复合麻醉下顺阿曲库铵的作用时间,并可抑制其肌松恢复.Objective To evaluate the effect of diabetes mellitus （DM） on cisatracurium-induced neuromuscular block when combined with sevoflurane anesthesia.Methods Thirty patients of both sexes,aged 30-60 yr,with body mass index of 18-25 kg/m2,scheduled for elective endoscopic sinus surgery,of ASA physical status Ⅰ or Ⅱ,were included in the study.The patients with type 2 DM and course of disease 〉 3 yr served as DM group （n =15）.Another 15 non-diabetic patients were included in thisstudy as control group （n =15）.Neuromuscular block was monitored with TOF-Watch（R） SX Monitor.The response of the adductor pollicis to TOF stimulation of the ulnar nerve was recorded after loss of consciousness.Anesthesia was induced with iv midazolam 0.05-0.10 mg/kg,fentanyl 3-5 tg/kg and propofol 1-2 mg/kg,and maintained with inhalation of.sevoflurane （endtidal concentration of 2 %） and infusion of remifentanil 0.1-0.3μg· kg-1 · min-1.No response time （duration of T1 =0）,clinical duration （time from end of injection to 25 % recovery of T1）,and recovery index （T1 from 25 %-75 %） were recorded.Results Compared with C group,no response time,clinical duration,and recovery index were prolonged in DM group.Conclusion DM can prolong the duration of action of cisatracurium when combined with sevoflurane anesthesia and inhibit the recovery of neuromuscular block.

关 键 词：糖尿病 阿曲库铵 神经肌肉阻滞 麻醉药 吸入 

分 类 号：R614[医药卫生—麻醉学]