新斯的明对米库氯铵术后恢复的影响  

The effect of Neostigmine on Mivacurium chloride in postoperative recovery

作　　者：李亚娟[1] 李庆民[1] 

机构地区：[1]泰山医学院附属泰山医院,山东泰安271000

出　　处：《泰山医学院学报》2015年第3期274-276,共3页Journal of Taishan Medical College

摘　　要：目的：观察研究新斯的明对米库氯铵术后恢复的影响，为临床合理用药提供依据。方法选择全麻择期手术患者45例，ASA分级Ⅰ～Ⅱ级。将患者随机分为三组，每组15例，随机分成新斯的明N50组（Ⅰ组），新斯的明N20组（Ⅱ组），对照组（Ⅲ组）。诱导后，使用异丙酚2～5 mg/（ kg·h）静脉输注，瑞芬太尼4μg/ml血浆靶控输注，米库氯铵0.15 mg/kg。Ⅰ组于TOF监测下T1恢复至基础值的20%时用新斯的明50μg/kg拮抗，Ⅱ组于TOF监测下T1恢复至基础值的20%时用新斯的明20μg/kg拮抗，Ⅲ组患者自然恢复。术中采用TOF刺激方式监测拇内收肌的收缩反应，进行肌松监测。观察恢复指数：是指从T1恢复至对照25%到T1恢复至对照75%的时间。结果三组的恢复指数分别为（22.51±3.06）min、（24.17±3.84）min和（25.74±4.02）min。结论在临床麻醉过程中新斯的明对米库氯铵术后的肌力恢复无明显意义。Objective：To investigate the effect of Neostigmine on Mivacurium Chloride in postoperative recovery so as to provide evidence for clinical rational drug use. Methods：45 ASAⅠ-Ⅱpatients under general anesthesia were randomly di-vided into three groups of 15 patients each,namely,Neostigmine N50 group（ GroupⅠ）,Neostigmine N20 group（ GroupⅡ） and contrast group（Group Ⅲ）. After induction,propofol 2~5mg/（kg·h）was injected by target-controlled infusion of Remifentanil（4 μg/ml）combined with Mivacurium Chloride（0. 15mg/kg）. In GroupⅠ,when T1 resumed to 20% of baseline value,Neostigmine（50μg/kg）was applied in antagonistic action by the monitoring of TOF . In GroupⅡ,when T1 resumed to 20% of baseline value,Mivacurium Chloride（20ug/kg）was applied in antagonistic action by the monitoring of TOF. In GroupⅢ,patients recovered naturally. TOF stimulation was applied to monitoring thumb adductorius contrac-tile response and to testing muscle relaxation. The recovery index observed referred to the duration when resumed from T1 to 25% and from T1 to 75% of contrast. Results：The recovery indexes of three groups were 22. 51 ± 3. 06 min,24. 17 ± 3. 84 min and 25. 74 ± 4. 02 min respectively. Conclusion：There is no obvious significance for Neostigmine to resume muscle force in Mivacurium Chloride postoperative recovery.

关 键 词：新斯的明 米库氯铵 药理学 

分 类 号：R614[医药卫生—麻醉学]