顺式阿曲库铵不同用药方式对老年全凭静脉麻醉肌松作用的影响

目的 探讨顺式阿曲库铵不同用药方式对老年患者全凭静脉麻醉肌松作用的影响.方法 60例掸期在全麻下行普外科手术的老年患者,ASA I～Ⅱ级.年龄7l～87岁,随机分为A组(η=20)和B组(η=40),其中B组再随机分为B1组(η=20)和B2组(η=20).肌松诱导:A组单次予顺式阿曲库铵0.2 mg·kg-1静注;B...

Effects of cisatracurium with different intravenous methods on the action of muscular relaxation for elderly total intravenous anesthesia

Objective To study the effects of different administration methods of cisatracurium on neuromuscular blockade in the elderly undergoing total intravenous anesthesia（TIVA）.Methods Sixty patients aged 71～87 undergoing TIVA were randomly assigned into Group A（n=20）,Group B1（n=20） and Group B2（n=20）.During anesthesia induction,Group A received saline placebo followed three minutes later by a single bolus dose of cisatracurium 0.2 mg·kg-1 iv.Patients in Group B1 and B2 received an initial dose of cisatracurium 0.02 mg·kg-1 iv followed three minutes later by cisatracurium 0.18 mg·kg-1 iv.During anesthesia maintenance,patients in Group B1 received intermittent dose of cisatracurium 0.03 mg·kg-1 iv when needed,and Group B2 received continuous infusion of cisatracurium 3 μg·kg-1·min-1.Neuromuscular function was assessed by accelerometry in response to single-twitch stimulation（T1） and train-of-four stimulation（TOF）.The time T1 recovered to 25%,50%,75%（t1,t2,t3） and T4/T1（TOFr） recovered to 0.7（TOFr 0.7） were recorded as well.Results 1.The onset in Group B was significantly shorter Group A（93±19 sec vs 201±32 sec,P0.05）.There was no significant difference on the maximum blockade between the two groups.2.The t1、t2、t3、TOFr 0.7 in Group B1 were longer than those in Group B2（P0.05）.There were no significant differences on the total amount of cisatricurium and recovery index（RI）between the two groups.Conclusion Elderly injected by intravenous a priming dose of cisatracurium can significantly shorten the onset,and the continuous infusion can provide better neuromuscular blockade effects and faster recovery.