靶控输注瑞芬太尼对顺式阿曲库铵起效时间的影响

目的探讨靶控输注瑞芬太尼对全麻患者顺式阿曲库铵起效时间的影响。方法 40例ASA I～II级择期手术患者,分为芬太尼组(C组)和瑞芬太尼组(R组)各20例,以加速度法四个成串刺激(TOF)监测肌松。两组均采用异丙酚血浆靶控输注模式进行诱导,C组静脉注射芬太尼3μg/kg,R组采用血浆靶控输注瑞芬太尼模式静脉输注瑞芬太尼,目标靶控浓度为目标血浆浓度4.5ng/ml。所有患者意识消失后,静脉给予顺式阿曲库铵0.15 mg/kg。观察并记录各组患者静脉注射顺式阿曲库铵结束至第四个TOF消失的时间(T4),注药结束至四个TOF都消失的时间(T0)及插管时生命体征和插管满意程度。结果两组T4和T0时间,插管时生命体征和插管满意度比较差异均无统计学意义(P>0.05)。结论麻醉诱导靶控输注瑞芬太尼对顺式阿曲库铵起效时间无影响。

Effect of remifentanil with target control infusion upon onset time of cisatracurium-induced neuromuscular

Objective To evaluate the effects of remifentanil with target control infusion upon onset time of cisatracurium in- duced-neuromuscular block during induction of anesthesia. Methods Forty patients （ ASA I or II） undergoing elective surgery under general anesthesia were randomly divided into 2 groups （n = 20 each） ：group R using remifentanil combined with propofol and group C using fentanyl combined with propofol. Neuromuscular function was monitored and recorded using acceleromyograpHy. Anesthesia was induced with propofol by TCI with target concentration 4 ~g/ml in the two groups. Then in group C, anesthesia was induced with fenta- nyl （3 I_Lg/kg, ） while in group R with TCI of remifentanil （ target plasma concentration at 4. 5 ng/ml）. Cisatracurium（0. 15 mg/kg） was injected after the patients loss of consciousness. The cisatracurium onset time T4 and T1 （ from the end of injection of cisatraeurium until 75% and 95% depression of T1 ） and tracheal intubating conditions were recorded. Results The onset time of neuromuscular block induced by cisatracurium in group R was compared with in group C, which was lower, but it was no significant difference between them（ P〉 0.05 ）. Conclusions Plasma target control infusion of remifentanil （model of minto） has no effect upon onset time of cisa- traeurium-induced neuromuscular block.