不同剂量新斯的明拮抗小儿罗库溴铵和维库溴铵的轻度残余肌松效应的比较

发布时间：2018-11-20 09:50

【摘要】：目的:比较麻醉恢复期新斯的明拮抗小儿罗库溴铵和维库溴铵的轻度残余肌松效应(RNMB),及新斯的明的适宜剂量。方法:择期全麻下患儿100例,随机分为罗库溴铵组和维库溴铵组,每组50例。采用加速度肌松监测仪监测4个成串反应的比值(TOFR)。当TOFR自然恢复至0.55时,两组患儿再随机分为5个亚组(n=10),分别给予新斯的明10、20、30、50μg/kg,及阿托品5、10、15、25μg/kg,对照组给予生理盐水2 m L。记录TOFR从0.55恢复至0.7、0.9、1.0的时间,计算新斯的明拮抗残余肌松效应的ED_(50)和ED_(95),随访术后6、24 h恶心呕吐的发生情况。结果 :两组患儿TOFR的恢复时间比较差异无显著性(P0.05)。不同剂量新斯的明均明显缩短TOFR的恢复时间(P0.01),较大剂量新斯的明(30、50μg/kg)的拮抗效果更显著(P0.05)。两组术后恶心呕吐发生率和新斯的明拮抗效应的ED_(50)、ED_(95)比较差异无显著性(P0.05)。结论:术后轻度残余肌松效应仍应进行拮抗,在TOFR恢复至0.55时,新斯的明拮抗小儿罗库溴铵和维库溴铵残余肌松效应的效果无明显差异,推荐使用30μg/kg的新斯的明进行拮抗。
[Abstract]:Aim: to compare the effect of neostigmine on mild residual muscle relaxation of rocuronium and vecuronium in children during recovery of anesthesia. Methods: 100 children under elective general anesthesia were randomly divided into rocuronium group and vecuronium group with 50 cases in each group. Using acceleration muscle relaxation monitor to monitor the ratio (TOFR). Of four strands reaction When TOFR recovered to 0.55, the two groups were randomly divided into 5 subgroups (nm10), which were given 30 渭 g / kg neostigmine (10 / 20), and atropine (51010) 1525 渭 g / kg, respectively. The control group was given normal saline 2 mL / kg. The time of TOFR recovery from 0.55 to 0.9m was recorded. The ED_ (50) and ED_ (95) of neostigmine against residual muscle relaxation were calculated. The incidence of nausea and vomiting was followed up for 6 to 24 hours after operation. Results: there was no significant difference in the recovery time of TOFR between the two groups (P 0.05). Different doses of neostigmine significantly shortened the recovery time of TOFR (P0.01), and the antagonistic effect of large dose of neostigmine (30 渭 g/kg) was more significant (P0.05). There was no significant difference in the incidence of nausea and vomiting and the antagonistic effect of neostigmine on ED_ (50) and ED_ (95) between the two groups (P0.05). Conclusion: the mild residual muscle relaxant effect should be antagonized after operation. When TOFR returns to 0.55, the effect of neostigmine on residual muscle relaxation of rocuronium and vecuronium in children has no significant difference. It is recommended to use 30 渭 g/kg neostigmine for antagonism.
【作者单位】：上海交通大学医学院附属第九人民医院麻醉科;
【分类号】：R726.1

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