摘要
目的观察阿曲库铵持续输注用于老年患者维持全麻肌松的临床效果。方法 40例拟行气管内全麻下择期手术的老年患者(ASAⅠ～Ⅱ),在常规进行快诱导及气管插管后5min内,首次静注阿曲库铵0.5mg/kg后,随机分为2组:A组,持续输注阿曲库铵0.3～0.5mg/(kg.h);B组,根据需要间断推注阿曲库铵0.2～0.3mg/kg。原则上以维持肌松程度恒定。A组于手术结束前25min停止给药,两组麻醉维持以安氟醚吸入及芬太尼间断静注,均待患者自主呼吸自然恢复(不予肌松药拮抗剂)。观察两组单位时间内阿曲库铵平均用药量(mg/(kg.min)、停止给药后肌松的恢复率(min)、手术结束至气管导管拔管时间(min)、手术结束前15min内因麻醉减浅而体动的例数及需要追加镇静药或镇痛药次数。结果两组患者一般情况、病种及手术时间差异无统计学意义(P>0.05);阿曲库铵平均总用量差异无显著性(0.40±0.05mg/(kg.h)vsB组0.40±0.07mg/(kg.h),P>0.05);肌松恢复率差异显著(A组15.4±5.5minvsB组28±6.1min,P<0.01);拔管时间差异显著(A组10.5±2.8minvsB组20.2±3.6min,P<0.01);手术结束前体动的例数A组少于B组(A组0次vsB组6次,P<0.05);需要追加镇静或镇痛次数(A组0次vsB组10次,P<0.05)。结论持续推注阿曲库铵用于老年患者维持全麻肌松是一种较为方便并易于控制的方法。
Objective To compare the clinical effects of atracurium by interval bolus or continuous infusion during surgery in the aged.Methods Forty ASAⅠ or Ⅱ elder patients undergoing elective surgery were randomly assigned to two groups（group A and group B,n=20 in each group）.Forty patients received an initial bolus of 0.5 mg/kg atracurium followed by an infusion of 0.3~0.5 mg/（kg·h）（group A） or by interval bolus of 0.2~0.3 mg/kg（group B）.The degree of neuronuscular blockade and recovery time of muscle relaxants were studied with morniting neuronuscular transmission by train-of four stimulation.The doses of atracurium and extubation time from the end of surgery were observed.Results The mean doses of atracurium in group A were 0.40±0.05 mg/（kg·h） vs 0.40±0.07 mg/（kg·h） in group B（P0.05）.The recovery time of muscle relaxants in group A was 15.4±5.5 min vs 28±6.1 min in group B（P0.05）.The extubation time from the end of surgery in group A was 10.5±2.8 min vs 20.2±3.6 min in group B（P0.01）.The lever of neuronuscular blockade with interval bolus was unatable and poorly controlled.Conclusion Conclusion Infusion of atracurium can be more easily controlled than intermitted administration during surgery in the aged patients.
出处
《中国实用医药》
2011年第28期41-42,共2页
China Practical Medicine
