七氟醚对不同剂量顺式阿曲库铵协同作用的比较

发布时间：2018-06-21 11:35

本文选题：七氟醚 + 顺式阿曲库铵　；参考：《中南大学》2014年硕士论文

【摘要】：目的：七氟醚可增强非去极化肌松剂的神经肌肉阻滞,既往研究多探讨此种协同作用与七氟醚相关因素如浓度、作用时间等的关系而鲜少研究其与肌松剂剂量之间是否存在关联。在细胞实验中发现七氟醚能够增强罗库溴铵对乙酰胆碱受体内向电流的抑制作用,并且在使用较小剂量的罗库溴铵时更为显著。本实验旨在临床上研究七氟醚对顺式阿曲库铵的协同作用是否与顺式阿曲库铵的剂量有关,是否有与细胞实验结果类似的在小剂量顺式阿曲库铵中七氟醚具有更为显著的协同作用。方法：选取全麻下行乳腺改良根治术患者60例,使用TOF-Watch监测仪监测肌松情况,将患者按所给顺式阿曲库铵剂量随机分入S组(0.10mg/kg)、M组(0.15mg/kg)和L组(0.20mg/kg),各组再按维持全身麻醉方式的不同分为PROP组(丙泊酚4-8ml/kg/h持续输注)和SEVO组(七氟醚2MAC持续吸入)。记录顺式阿曲库铵的起效时间(t0)、维持时间(tm)、恢复时间(tr)与此时的T1值、手术结束至拔除喉罩时间(tex)及术前与术后拔除喉罩20分钟时血氧饱和度和术后Steward苏醒评分。结果：各组t0时间差异均无统计学差异(P0.05)；各组SEVO组tm均较PROP组延长(P0.05)并以S组最为显著(P0.05)；各组SEVO组tr均较PROP组延长(P0.05)并以S组最为显著(P0.05)；各组SEVO组tex均较PROP组延长(P0.05)；各组术前与术后拔除喉罩20分钟时血氧饱和度和术后Steward评分均无显著差异(P0.05)。结论：七氟醚可以延长不同剂量顺式阿曲库铵的作用时效,当顺式阿曲库铵的剂量越小时七氟醚对其协同作用越显著,表22个,图
[Abstract]:Objective: sevoflurane can enhance neuromuscular block of non-depolarized muscle relaxant. The relationship between the time of action and the dose of muscle relaxant was seldom studied. It was found that sevoflurane could enhance the inhibitory effect of rocuronium on the inward currents of acetylcholine receptor, especially when the dose of rocuronium was lower. The aim of this study was to investigate whether the synergistic effect of sevoflurane on cis-atracurium is related to the dose of cis-atracurium. Whether there is a more significant synergistic effect of sevoflurane in low dose cis-atracurium similar to the results of cell experiments. Methods: 60 patients with modified radical mastectomy under general anesthesia were selected to monitor muscle relaxation with TOF-Watch monitor. Patients were randomly divided into group S (0.10 mg / kg) and group L (0.20 mg / kg) according to the dose of cis-atracurium. Each group was divided into prop group (propofol 4-8ml/kg/h continuous infusion) and sevoxide group (sevoflurane 2MAC continuous inhalation) according to the maintenance of general anesthesia. The onset time, maintenance time, recovery time and T1 value of cis atracurium were recorded. The time from operation to removal of larynx mask was recorded. The oxygen saturation of blood and Steward's recovery score after operation and 20 minutes after removal of laryngeal mask were recorded. Results: there was no significant difference in the time of t0 in each group (P 0.05); the tm of each group was longer than that of prop group (P 0.05), especially in S group (P 0.05); the tr of each group was longer than that of prop group (P 0.05), and the most significant difference was that of group S (P 0.05); the tex of each group was longer than that of Prop group (P 0.05). There was no significant difference in blood oxygen saturation and Steward score before and after laryngeal mask removal in each group (P 0.05). Conclusion: sevoflurane can prolong the effect of different doses of cis-atracurium. The more dose of cis-atracurium, the more significant the synergistic effect of sevoflurane is.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614

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