硫酸镁对子痫前期产妇剖宫产术米库氯铵作用时效的影响  

Influence of magnesium sulphate on time-effect of mivacurium in women with preeclampsia during caesarean section

作　　者：张望平[1,2] 肖飞[2] 祝胜美[1] 

机构地区：[1]浙江大学医学院附属第一医院麻醉科,浙江杭州310000 [2]嘉兴市妇幼保健院麻醉科,浙江嘉兴314000

出　　处：《中国新药与临床杂志》2014年第8期612-615,共4页Chinese Journal of New Drugs and Clinical Remedies

摘　　要：目的探讨硫酸镁对子痫前期产妇米库氯铵起效及作用时间的影响。方法选择60例拟行剖宫产的子痫前期产妇随机分为两组,每组30例。观察组诱导前5 min缓慢静脉注射(静注)硫酸镁10 mL(2.5 g),对照组静注氯化钠注射液10 mL。全麻诱导:依次静脉注射瑞芬太尼0.6μg·kg-1、丙泊酚2 mg·kg-1、米库氯铵0.2 mg·kg-1,采用4个成串刺激(TOF)监测肌松,拉贝洛尔20 mg静注后2 min行气管插管机械通气。记录肌松药起效时间、时效、恢复指数,麻醉前(t0)、静注硫酸镁后(t1)、胎儿娩出时(t2)、手术结束(t3)时的血流动力学情况,新生儿行Apgar评分及脐动脉血气分析。结果给硫酸镁后,观察组与对照组间收缩压有显著差异[(149.0±11.8)vs.(161.6±16.4)mmHg,P<0.05];观察组肌松起效时间短于对照组[(112.6±13.2)vs.(124.4±16.5)s],但作用时间[(25.4±6.9)vs.(20.6±5.8)s]和恢复指数[(15.5±4.6)vs.(12.7±3.1)min]均长于对照组(P<0.05);两组新生儿Apgar评分及脐动脉血气分析比较无显著差异(P>0.05)。结论硫酸镁可缩短子痫前期产妇米库氯铵的起效时间,延长作用时间,提高恢复指数。AIM To observe the influence of magnesium sulphate on time-effect of mivacurium in women with preeclampsia during caesarean section. METHODS A total of 60 women of preeclampsia undergoing caesarean section were selected and randomly allocated to experiment group and control group （each n= 30）. The experiment group was injected intravenously with magnesium sulfate 10 mL （2.5 g） 5 min before induction, and the control group with intravenous injection of sodium chloride injection 10 mL. Anesthesia was induced with intravenous injection of propofol 2 mg ·kg^-1, rimifentanil 0.6 μg·kg^-1 and mivacurium 0.2 mg ·kg^-1. The train of four （TOF） stimulation was used to monitor the degree of neuromusclar blockade, and endotracheal intubation was be done 2 min after intravenous injection of labetalol 20 mg. The onset time, action time, recovery index and the hemodynamic situation before the anesthesia （to） , after intravenous injection of magnesium sulphate （h）, fetal disengagement （t2）, and end of operation （t3） were collected. Apgar score and blood gas analysis of umbilical artery blood was be done to newborns. RESULTS Compared with the control group, the experiment group had significant difference in SBP after intravenous injection of magnesium sulphate （ 149.0 ±11.8） vs. （161.6±16.4） mmHg, P 〈 0.05）. The onset time was shorter （（112.6 ± 13.2） vs （124.4 ± 16.5） s）, but the duration time of neuromusclar blockade （（25.4±6.9） vs. （20.6 ± 5.8） s） and the recovery index （（ 15.5 ± 4.6） vs. （ 12.7 ± 3.1） min） was longer than those in the control group （P 〈 0.05） . Blood gas analysis of umbilical arterial blood and Apgar scores were not significantly different in both groups （P 〉 0.05） . CONCLUSION Magnesium sulphate can shorten the onset time of mivacurium in women with preeclampsia during caesarean section, prolong the action time, and increase the recovery index.

关 键 词：硫酸镁 子痫前期 米库氯铵 

分 类 号：R971[医药卫生—药品] R719[医药卫生—药学]