【摘要】 目的 观察不同浓度异氟醚对罗库溴铵肌松作用的影响。方法 60例ASA Ⅰ-Ⅱ择期手术患者,随机分为3组,每组20例。组Ⅰ静脉注射罗库溴铵0.6 mg·kg-1;组Ⅱ吸入0.6％异氟醚后静脉注入罗库溴铵0.6mg·kg-1;组Ⅲ吸入1.2％异氟醚后从静脉注入罗库溴铵0.6mg·kg-1。分别记录各组注药后肌松作用的起效时间、作用时间及T1恢复时间。结果 与组Ⅰ相比,组Ⅱ、Ⅲ起效时间明显缩短(P<0.05),TOF无反应期明显延长(P<0.01),T1恢复25％、50％、90％时间明显延长(P<0.01),且组Ⅲ较组Ⅱ延长(P<0.05),恢复指数明显延长,且组Ⅲ较组Ⅱ延长(P<0.05)。结论 吸人异氟醚能明显缩短罗库溴铵起效时间,延长罗库溴铵作用时间,临床合并使用时应注意减少用量。更多还原

【Abstract】 Objective To evaluate the potentiation of neuromuscular block produced by rocuronium during isoflurane anesthesia. Methods Sixty ASA Ⅰ -Ⅱ patients (39 male, 21 female), aged 18-56 yr, weighing 42-88 kg undergoing ENT, oral or facial plastic surgery were enrolled in this study. The patients were premedicated with atropine 0.01 mg·kg-1 . Anesthesia was induced with diazepam 0.1 mg·kg-1 , pethidine 1mg·kg-1 and droperidol 50μg·kg-1. Oro- or naso-tracheal intubation was accomplished under topical anesthesia. After intubation the patients received hydroxydione 2.5 g and fentanyl 5 μg·kg-1 . The patients were mechanically ventilated. Anesthesia was maintained with inhalation of 50% N2O in O2 alone (groupⅠ) or combined with 0.6% isoflurane (group Ⅱ ) or 1.2% isoflurane (group Ⅲ ) . A bolus of rocuronium 0.6 mg·kg-1 was given during maintenance of anesthesia. Neuromuscular function was monitored using TOF response measured by accelerography (Biometer, Denmark). (1) Onset time (time from the end of injection to maximum depression of T1 ) , (2) the duration of T1 = 0, (3) time from the end of injection to recovery of T1 to 25% , 50% and 90% control, (4) recovery index (time from T, 25%-75%) were recorded. End-tidal isoflurane concentration was monitored.Results The onset time was significantly longer in group Ⅰ[ (1.7±0.2) min] than that in group Ⅱ[ (0.9±0.1) min] and groupⅢ[(0.8±0.1) min] ( P < 0.05). The clinical duration of action (duration of T1 = 0) was significantly prolonged in groupⅡ [(35.8±7.9) min] and group Ⅲ[ (42.2±10.1) min] as compared to that in group Ⅰ [(20.0±5.1) min] (P < 0.01). The time of T1 recovery to 25% , 50% and 90% control and recovery index were significant longer in group Ⅱ andⅢ than those in group Ⅰ ( P < 0.05) .Conclusion Isoflurane significantly potentiates the neuromuscular block induced by rocuronium. The dose of rocuronium should be reduced when used with isoflurane.更多还原