摘要
目的:研究地氟醚呼气末浓度对新斯的明拮抗罗库溴铵肌松作用的影响。方法:80例择期全麻手术病人随机分成地氟醚麻醉组(D组,维持地氟醚呼气末体积浓度6%)和异丙酚麻醉组(P组,维持异丙酚靶控输注效应室质量浓度4μg/mL),首量1.5倍ED95罗库溴铵保持肌松。当TOF的T1恢复到20%时,将D组病人分成D-1组(维持地氟醚呼气末体积浓度6%)及D-2和D-3组(地氟醚呼气末体积浓度分别降到4.2%和2.4%);将P组病人分成P-1组(维持异丙酚靶控输注效应室质量浓度4μg/mL)和P-2组(异丙酚靶控输注效应室质量浓度降到1.5μg/mL)。T1恢复到25%时给予新斯的明。记录T1和TOFr恢复过程。结果:给予新斯的明后P-1组和P-2组的T1恢复时程基本相同。D-1组和D-2组的T1恢复时程亦基本相似,但恢复时间均明显比D-3组长。而D-3组的恢复指数以及T1恢复到95%和100%的时间和P-1组、P-2组基本相同。结论:0.4MAC地氟醚对罗库溴铵肌松效应无明显影响。0.7MAC地氟醚能增强罗库溴铵的肌松效应,影响程度与1.0MAC地氟醚相似,延迟新斯的明拮抗罗库溴铵肌松作用的时间。
Objective： To study the influence of end-tidal concentration of desflurane on neostigmine antagonism of rocuronium-induced neuromuscular block. Method： 80 patients undergoing selective surgeries were randomized into one of two groups. After intravenous propofol （2 mg/kg ） and fentanyl （4μg/kg ） , anesthesia maintainance was achieved by desflurane inhalation （ end-tidal concentration 6.0 Vol% ） in group D （ n = 48 ） and target controlled infusion of propofol （ effect compartment concentration 4 μg/mL） in group P （ n = 32 ） , respectively. In both groups, neuromuscular block was induced with roeuronium and monitored using train-of-four （TOF） stimulation of the ulnar nerve. When the first response in TOF （T1 ） had recovered to 20% , patients in each group were randomly assigned into sub-groups. End-tidal concentration of desflurane and effect compartment concentration of propofol were maintained the same as before in group D-1 and group P-1, while were decreased to 4.2Vo1% or 2.4Vo1% and 1.5μg/ml in group D-2, group D-3 and group P-2, respectively. Neostigmine was given when T1 had recovered to 25%. The time points of T1 25% , 30% , 75% , 95% , 100% recovery and TOFr 0. 8 were recorded. Results： There were no any significant differences between group P1 and P2 with respect to T1 recovery time （ P 〉 0. 05 ）. The time length of T1 recovering to 30% , 50% , 75% , 95% and 100% in group D-1 and D-2 were apparently longer than those in group D- 3, while those in group D-3 were similar to those in group P-1 and P-2. Conclusion ： Inhalation of desflurane 0. 7 MAC significantly enhanced the neuromuscular block and delayed the onset of neostigmine as an antagonist of rocuronium, but there was no significant synergism between desflurane 0. 4 MAC and rocuronium.
出处
《广州医学院学报》
2005年第5期30-32,共3页
Academic Journal of Guangzhou Medical College
基金
广州医学院研究课题(02-k-12)
