【摘要】 目的:研究罗库溴铵和顺苯磺酸阿曲库铵对冠状动脉搭桥术病人肌松时效和血流动力学变化的影响。方法:选择ASA 3~4级、择期行冠状动脉搭桥术的病人20例,随机分为罗库溴铵组(0.6 mg/kg,Ⅰ组,10例)和顺苯磺酸阿曲库铵组(0.2 mg/kg,Ⅱ组,10例)。用四成串刺激(TOF)监测拇内收肌颤搐反应,监测平均动脉压和心率,比较两组肌松时效差异及其对血流动力学的影响。结果:Ⅰ、Ⅱ两组起效时间分别为59±12 sec和98±23 sec,P<0.05;临床时效分别为35±6.3 min和43±5.9 min,P>0.05;Ⅰ组注药后各时间点与注药前比较,MAP和HR无明显变化;Ⅱ组注药后各时间点与注药前比较及与Ⅰ组各对应时间点比较,MAP明显下降,HR明显增快,P<0.05。结论:与顺苯磺酸阿曲库铵比较,罗库溴铵起效迅速,对冠状动脉搭桥术病人血流动力学无明显影响。更多还原

【Abstract】 Objective To study the effect of rocuronium and cisatracurium in neuromuscular efficacy and hemodynamic changes on patients undergoing coronary artery bypass graft(CABG).Methods Twenty patients,ASA grade 3~4,undergoing CABG were clinically ramdomized to receive either 0.6 mg/kg rocuronium(groupⅠ,n=10) or 0.2 mg/kg cisatracurium(group Ⅱ,n=10),Twitch response to a course of four electrical stimulations,mean artery blood pressure(MAP) and heart rate(HR) were monitored so as to compare the time-respone difference and hymodynamic changes between the two groups.Results The onset time of neuromuscular block was 59±12 sec in groupⅠ,vs.98±23 sec in groupⅡ(P<0.05);The clinical effective time was 35±6.3 min in groupⅠ,vs.43±5.9 min in groupⅡ(P>0.05);Rocuronium didn,t produce significant changes in MAP and HR at all times(P >0.05),but cisatracurium produced significant reduction of MAP and increased HR at all times(P <0.05).Conclusion Rocuronium provides more suitable conditions for rapid treached intubation than cisatracurium,is associated with a quicker onset time,has less effect on MAP and HR when compared to cisatracurium in patients undergoing CABG.更多还原