右美托咪定对维库溴铵肌松效应的影响

目的探讨右美托咪定对维库溴铵的起效时间及临床作用时间的影响。方法择期全麻手术患者50例,将其随机分为右美托咪定组(D组)和对照组(C组),每组25例。采用TOF-Watch SX加速度肌松监测仪以四个成串刺激方式刺激尺神经,监测拇内收肌的收缩反应。D组麻醉诱导前15 min静脉预注右美托咪定首剂量1.0μg/kg,然后以0.5μg/(kg·h)的速度维持。C组同法输注等量的0.9%氯化钠注射液。记录给首剂量前、给首剂量后即刻、插管前即刻、插管后15 min、插管后30 min的平均动脉压和心率;记录维库溴铵起效时间及临床作用时间。结果 D组给首剂量后各时点平均动脉压和心率均较C组低,差异有统计学意义(P0.05),两组维库溴铵的起效时间差异无统计学意义(P0.05),D组临床作用时间明显延长,差异有统计学意义(P0.05)。结论麻醉时合并应用右美托咪定不影响维库溴铵的起效时间,但可延长其临床作用时间。

Effects of dexmedetomidine on vecuronium-induced neuromuscular blockade

Objective To investigate the effects of dexmedetomidine （DEX） on the onset time and clinical duration of vecuronium （VEC）. Methods 50 patients undergoing elective surgery under general anesthesia, were randomly divided into DEX group （group D） and control group （group C）, 25 cases in each group. The responses of adductor pollicis to train of four （TOF）stimulation of utnar nerve were monitored by TOF-Watch SX accelerometer.The patients in group D were infused intravenous with the first dose of DEX 1 μg/kg 15 min before anesthetic induction,then maintained at a rate of 0.5 μg/（kg·h）. Group C was infused in the same way with 0.9% sodium chloride. Before and after the first dose, the mean arterial pressure, heart rate, the onset time and clinical duration of VEC were recorded. Results The mean arterial pressure and heart rate at each time point after the first dose were lower in group D than those in group C （P〈 0.05）. There were no significant differences in the onset time of VEC between the two groups, but the clinical duration was longer in group D （P〈0.05）. Conclusion Anesthesia combined with application of DEX does not affect the onset time of VEC, but prolongs its clinical duration.