顺式阿曲库铵持续输注与间断给药对肌松残余作用的影响研究  

Research on cisatracurium continuous infusion and intermittent dosing on the residual effect of muscle relaxant

作　　者：杨雪 

机构地区：[1]河南省许昌市中心医院,461000

出　　处：《中国实用医刊》2017年第22期97-101,共5页Chinese Journal of Practical Medicine

摘　　要：目的观察顺式阿曲库铵持续输注与间断给药对肌松残余作用的影响。方法80例行腰椎管狭窄手术的患者随机分为顺式阿曲库铵持续输注组与顺式阿曲库铵间断输注组，每组患者40例。顺式阿曲库铵持续输注组采用微量泵持续输注顺式阿曲库铵1.5 μg/（kg·min），顺式阿曲库铵间断输注组采用静脉间断输注顺式阿曲库铵0.1 mg/（kg·h），两组顺式阿曲库铵使用总量相等。记录两组顺式阿曲库铵的使用总量、麻醉总有效率，比较组血流动力学变化、呼吸指标变化、患者四个成串刺激比值（TOFr）达到25%、50%、75%、90%的时间及肌松检测临床指标。结果持续输注组术中麻醉总有效率为90%，明显高于间断给药组的72.5%，差异有统计学意义（P〈0.05）；术前两组患者的心率分别为（76.68±9.72）、（74.08±7.65）次/min，低于术后的（88.90±7.51）、（89.95±6.53）次/min，差异有统计学意义（P〈0.01）；两组患者术前潮气量分别为（327.3±13.17）、（332.58±10.53）ml，低于术后的（428.15±12.93）、（433.20±11.18）ml，P〈0.05；术后持续输注组TOF＝25%的时间为（43.37±12.94）min，明显高于间断给药组的（28.06±23.83）min，差异有统计学意义（P〈0.05）；术后持续输注组持续抬头5 s的时间为（60.01±12.35）min，高于间断给药组的（50.74±16.34）min，P〈0.05。结论手术过程中顺式阿曲库铵持续输注能够维持满意的肌松效果，减少手术中顺式阿曲库铵的用量，延长肌松恢复时间，且无明显不良反应。Objective To observe the effect of cisatracurium continuous infusion and intermittent dosing on the residual effect of muscle relaxant.MethodsEighty patients underwent selective spinal surgery were randomly divided into continue infusion group and intermittent infusion group, with 40 cases in each group. The patients in continue infusion group received cisatracurium by continue infusion with 1.5 μg/（kg·min）, and the patients in intermittent infusion group received cisatracurium by intermittent bolus infusion with 0.1 mg/（kg·h）, the total doss of cisatracuium of the two groups were the same. The total use of cisatracurium and total effective rate of anesthesia of the two groups was recorded, The hemoclynamic changes, respiratory index changes and TOFr recovered to 25%, 50%, 75%, 90%. Clinical indexs of muscle relaxation test were compares between the two groups.ResultsThe total effective rate of anesthesia in continued infusion group（90%）was significantly higher than that in the intermittent infusion group（72.5%, P〈0.05）; the heart rate before the surgery in the two group were （76.68±9.72）bpm, （74.08±7.65）bpm, which were significantly lower than those after surgery [（88.90±7.51）bpm, （89.95±6.53）bpm]（P〈0.01）; the tidal volume before surgery in the two groups were （327.3±13.17）ml, （332.58±10.53）ml, which were significantly lower than that after surgery[（428.15±12.93）ml, （433.20±11.18）ml]（P〈0.05）; the duration of tof=25% in the continuous infusion group was （43.37±12.94）min, which was significantly higher than that in the intermittent infusion group[（28.06±23.83）min]（P〈0.05）; the time of continue to look up 5 s in continued infusion group was（60.01±12.35）min, which was significantly higher than that in the intermittent infusion group[（50.74±16.34）min, P〈0.05].ConclusionsThe operation process of cisatracurium in continuous infusion can maintain satisfactory muscle relaxant effect, reduce the dosage of cisatracurium ope

关 键 词：顺式阿曲库铵 肌松残余作用 四个成串刺激比值 肌松恢复 

分 类 号：R687.3[医药卫生—骨科学]