不同预注间期对缩短罗库溴铵起效时间的影响  

Effects of different priming intervals injection on the onset time of rocuronium

作　　者：王颖林[1] 罗琳[1] 董盛龙[1] 田国刚[1] 

机构地区：[1]中南大学湘雅医学院附属海口医院麻醉科,570208

出　　处：《临床麻醉学杂志》2014年第9期851-854,共4页Journal of Clinical Anesthesiology

摘　　要：目的探讨不同预注间期对缩短罗库溴铵起效时间的影响。方法成人择期全麻下腹部手术患者80例,男40例,女40例,年龄18～60岁,ASAⅠ或Ⅱ级,随机分为四组。Ⅰ组、Ⅱ组、Ⅲ组均静脉预注罗库溴铵0.06mg/kg,并分别在预注1、2、3min后静脉注射罗库溴铵0.54mg/kg;Ⅳ组静脉预注等体积的生理盐水,并在预注3min后静脉注射罗库溴铵0.6mg/kg。在注射罗库溴铵插管剂量前1min顺序给予丙泊酚1.5mg/kg、芬太尼4μg/kg。四个成串刺激(TOF)模式下T1值<15%时进行气管插管。记录注射插管剂量罗库溴铵前(T1)、气管插管前(T2)、气管插管后即刻(T3)、气管插管后1min(T4)、气管插管后3min(T5)的MAP、HR、SpO2变化,监测并记录静脉注射插管剂量罗库溴铵前的T1值、TOF值和起效时间,评估气管插管条件,记录患者呼吸困难等不良反应的发生情况。结果与Ⅳ组比较,T3、T4时Ⅱ组、Ⅲ组患者的MAP明显降低、HR明显减慢(P<0.05);T1时Ⅱ组、Ⅲ组患者的T1值、TOF值明显降低,起效时间明显缩短(P<0.05),且Ⅲ组患者的T1值、TOF值明显低于、起效时间明显短于Ⅱ组(P<0.05);四组患者的气管插管条件评级差异无统计学意义;所有患者无呼吸困难、吞咽困难、复视等不良反应。结论预注间期为3min的预注法可以明显缩短罗库溴铵的起效时间。Objective To compare the effects of different priming intervals with the standard intubation dose of rocuronium on the onset time and intubation conditions.Methods Eighty adult patients were randomly assigned to four groups（n=20each）.Patients in groupⅠ,Ⅱ,Ⅲall received a dose of rocuronium 0.06mg/kg,then rocuronium 0.54mg/kg were administered 1min later in groupⅠ,2min later in groupⅡ and 3min later in groupⅢ.GroupⅣ received a pri ming placebo injection followed by rocuronium 0.60mg/kg 3min later.All patients received propofol 1.5mg/kg and fentanyl 4μg/kg 1min before injection of intubation dosage of rocuronium.Then the patients were intubated when T1〈15%in the train of four（TOF）stimulation mode.MAP,HR and SpO2 were monitored at following time points,before injection of intubation dose of rocuronium（T1）,before intubation（T2）,after intubation（T3）,1min after intubation（T4）,3min after intubation（T5）.Onset time and intubation conditions after intubatinon dose were evaluated by using TOF stimulation mode.Results At time point T3 and T4,the values of MAP were lower and HR were slower in groupⅡ and groupⅢthan those in groupⅣ（P〈0.05）.At time point T1,the values of T1,TOF and onset time for intubation were lower in groupⅡ and groupⅢthan those in groupⅣ（P〈0.05）.There was no significant difference in intubation conditions among the groups.No adverse reactions,such as dyspnea,dysphagia,and diplopia happened after pri ming injection of rocuronium in all the groups.Conclusion Pri ming with a 3min pri ming interval is more effective when rapid tracheal intubation with rocuronium is necessary.

关 键 词：罗库溴铵 预注法 气管插管 

分 类 号：R614[医药卫生—麻醉学]