不同浓度地氟烷对女性患者顺阿曲库铵肌松效应的影响

发布时间：2018-01-26 01:20

本文关键词： 地氟烷顺阿曲库铵肌松弛女性　出处：《中国新药与临床杂志》2015年05期 　论文类型：期刊论文

【摘要】：目的探讨不同浓度地氟烷吸入对女性患者顺阿曲库铵肌松效应的影响。方法 80例全麻下行妇科附件短小手术患者随机分为四组,每组20例。四组均采用喉罩下全麻,麻醉诱导后插入双腔喉罩,且均予丙泊酚和瑞芬太尼(效应室靶浓度4μg·L-1)维持麻醉。丙泊酚组丙泊酚血浆靶控浓度5 mg·L-1,地氟烷低、中、高剂量组丙泊酚血浆靶控浓度2.5 mg·L-1,并吸入0.65、1、1.3倍最低肺泡有效浓度的地氟烷。四组均于插入喉罩45 min后静脉注射顺阿曲库铵0.15 mg·kg-1。记录各组肌松起效时间,第一个肌颤搐振幅(T1)持续为0及其恢复到5%、25%、50%、75%、90%的时间,恢复指数(RI,T1恢复25%到75%时间),并观察不良反应发生情况。结果地氟烷低、中剂量组肌松起效时间短于丙泊酚组,但差异无显著意义(P0.05),地氟烷高剂量组起效时间短于丙泊酚组(P0.05)。地氟烷各剂量组T1持续为0及其恢复到5%、25%、50%、75%、90%的时间长于丙泊酚组(P0.05),中剂量组长于低剂量组、高剂量组长于中剂量组(P0.05)。地氟烷低剂量组RI与丙泊酚组无显著差异(P0.05),地氟烷中、高剂量组RI均长于丙泊酚组,高剂量组长于中剂量组(P0.05)。四组均未出现皮疹、心动过缓、低血压和支气管痉挛等不良反应。结论吸入地氟烷能增强女性患者顺阿曲库铵的肌松效应,其强化作用随地氟烷浓度增加而增强。
[Abstract]:Objective to investigate the effect of desflurane inhalation at different concentrations on the muscle relaxation effect of cisatracurium in female patients. Methods 80 cases of gynecological appendage short operation under general anesthesia were randomly divided into four groups. 20 cases in each group were treated with general anesthesia under laryngeal mask, and the double lumen larynx mask was inserted after anesthesia induction. Propofol and remifentanil (4 渭 g 路L ~ (-1)) were used to maintain anesthesia. In propofol group, the plasma target control concentration of propofol was 5 mg 路L ~ (-1), desflurane was low and medium. The plasma target controlled concentration of propofol was 2.5 mg 路L -1 in the high dose group, and the dose of propofol was 0.65g 路L -1. Desflurane, 1.3 times the lowest effective alveolar concentration, were injected intravenously with cisatracurium 0.15 mg 路kg-1.The onset time of muscle relaxation was recorded in all four groups after 45 min of laryngeal mask insertion. The first twitching amplitude T _ 1) continued to be 0 and recovered to 5 ~ 25, 50 and 75 ~ 90%, and the recovery index was 25% to 75% times (r ~ (I) T _ (1) was 25% to 75%). Results the onset time of muscle relaxation in middle dose group was shorter than that in propofol group, but there was no significant difference (P 0.05). The onset time of desflurane in high dose group was shorter than that in propofol group (P 0.05). T1 of desflurane group continued to be 0 and recovered to 50.25%. The time of 90% was longer than that of propofol group (P 0.05), and that of middle dose group was longer than that of low dose group. The RI of desflurane low dose group was not significantly different from that of propofol group. In desflurane group, RI of high dose group was longer than that of propofol group. The high dose group was longer than the middle dose group (P 0.05). No rash and bradycardia were found in the four groups. Conclusion inhaled desflurane can enhance the muscle relaxation effect of cisatracurium in female patients.
【作者单位】：海盐县妇幼保健院麻醉科;浙江大学医学院附属邵逸夫医院麻醉科;
【分类号】：R614
【正文快照】： 顺阿曲库铵(cisatracurium)是阿曲库铵(atracurium)的顺式旋光异构体,无组胺释放效应,对心血管影响轻微,对肝、肾功能依赖少,但与其他非去极化肌松药一样,其肌松效应也受吸入麻醉药的影响[1]。地氟烷(desflurane)具有组织溶解度低、在体内几乎无代谢、苏醒迅速等优点,在临床应

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