顺磺酸阿曲库铵持续与间断给药不同剂量对椎体骨折患者肌松残余作用的影响  

Effects of continuous and intermittent administration of different doses of cisatracurium on residual neuromuscular blockade of patients with vertebral fractures

作　　者：李昌伟[1] 李红军[1] 

机构地区：[1]枣阳市第一人民医院,湖北441200

出　　处：《实用药物与临床》2015年第1期52-55,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨顺磺酸阿曲库铵持续与间断给药不同剂量对椎体骨折患者肌松残余作用的影响。方法选取我院近年来收治椎体骨折患者120例,采用随机数字表法分为4组,即A组、B组、C组和D组,每组30例;A组患者给予微量泵持续输注顺磺酸阿曲库铵1.0μg/(kg·min),B组患者给予微量泵持续输注顺磺酸阿曲库铵0.5μg/(kg·min),C组患者给予静脉间断输注顺磺酸阿曲库铵1.0μg/(kg·min),D组患者给予静脉间断输注顺磺酸阿曲库铵0.5μg/(kg·min);四组顺磺酸阿曲库铵使用总量相同;比较四组患者麻醉效果,TOFr恢复时间(25%、50%、75%及90%),顺磺酸阿曲库铵使用量,拔管时间,初次睁眼时间,肌力恢复至Ⅳ级及以上时间及持续抬头5 s时间。结果四组患者麻醉总有效率比较差异无统计学意义(P>0.05);A组患者TOFr=25%恢复时间、TOFr=50%恢复时间及TOFr=75%恢复时间均显著长于其他3组,差异有统计学意义(P<0.05);A组和C组患者TOFr=90%恢复时间比较差异无统计学意义(P>0.05);B、C组患者TOFr=50%恢复时间、TOFr=75%恢复时间及TOFr=90%恢复时间均显著长于D组,差异有统计学意义(P<0.05)。四组患者顺磺酸阿曲库铵使用量比较差异无统计学意义(P>0.05);四组患者拔管时间和初次睁眼时间比较差异无统计学意义(P>0.05);A组患者肌力恢复至Ⅳ级及以上时间和持续抬头5 s时间均显著长于B组、D组,差异有统计学意义(P<0.05);A组和C组患者肌力恢复至Ⅳ级及以上时间、持续抬头5 s时间比较差异无统计学意义(P>0.05)。结论顺磺酸阿曲库铵持续与间断给药对椎体骨折患者肌松残余作用、麻醉效果均无明显影响,但持续大剂量输注可延长肌松恢复时间。Objective To investigate the effects of continuous and intermittent administration of different doses of cisatracurium on residual neuromuscular blockade of patients with vertebral fractures. Methods 120 patients with vertebral fractures were chosen in recent years in our hospital and randomly divided into 4 groups ： group A （ n = 30） received continuous infusion of cisatracurium by micro pump of 1.0 μg/（ kg. min）, group B （n = 45 ）was given continuous infusion of cisatracurium by micro pump of 0. 5 p.g/（ kg· min） , group C （n = 45 ）received intermittent infusion of cisatracurium of 1.0 μg/（ kg· min） , group D （ n = 45 ） received intermittent infusion of cisatracurium of 0. 5 μg/ （ kg · min ） ; and the anesthesia effect, recovery time of TOFr （ 25 % , 50 % , 75 % and 90 % ） , cisatracurium dosage, time of extubation, the first eye opening time, time of muscle strength recovered to grade IV and continuing look up 5 s time of 4 groups were compared. Results There was no significant difference in total effect of anesthesia among 4 groups （ P 〉 0. 05 ）. The recovery time of TOFr = 25 %/50%/75 % of group A was significantly longer than those of group B, group C and group D（ P 〈 0. 05 ）. There was no significant difference in recovery time of TOFr = 90% between group A and group C（ P 〉 0. 05 ）. The recovery time of TOFr = 50%/75%/90% of group B and group C was significantly longer than group D（ P 〈 0. 05 ）. There was no significant difference in cisatracurium dosage among the 4 groups （P 〉 0.05 ）. There was no significant difference in time of extubation and the first eye opening time among the 4 groups （ P 〉 0.05 ）. The time of muscle strength recovered to grade IV and continuing look up 5 s of group A and group C was significantly longer than group B and group D （ P 〈 0. 05 ）. There was no significant difference in time of muscle strength recovered to grade IV and continuing look up 5 s between group A and group C （ P 〉 0.05 ）

关 键 词：顺磺酸阿曲库铵 输注方式 剂量 椎体骨折 肌松残余作用 

分 类 号：R614[医药卫生—麻醉学]