加快顺式阿曲库铵全麻诱导起效的临床研究

目的 本研究以3ED95顺式阿曲库铵分别联合不同低剂量阿曲库铵用于麻醉诱导,与单独使用3ED95和4ED95顺式阿曲库铵比较,旨在探索联合用药加快起效时间的临床效应.方法 选择ASA分级Ⅰ～Ⅱ级,需全麻下手术的患者80例,随机分为4组.A组,顺式阿曲库铵0.15 mg/kg;B组,顺式阿曲库铵0.20mg/kg;C组,顺式阿曲库铵0.15mg/kg联合阿曲库铵0.10mg/kg;D组,顺式阿曲库铵0.15mg/kg联合阿曲库铵0.20 mg/kg.使用肌松监测仪进行拇内收肌肌松监测,诱导均采用咪唑安定0.05mg/kg,芬太尼4ug/kg,依托咪酯0.3 mg/kg,T1/Tc＜10％时气管插管.记录各组肌松效应起效时间、插管条件评级及MAP、HR、SpO2变化.结果 各组患者插管条件及相应时间点血液动力学参数无统计学差异.B、C、D组起效时间加快,其中C、D组与A组比较有统计学差异(P＜0.05),B组虽起效时间短于A组,但无统计学差异(P＞0.05).结论 3ED95顺式阿曲库铵联合少量的阿曲库铵可以显著缩短起效时间,效果优于4ED95顺式阿曲库铵,不影响血液动力学参数,更有利于全麻气管插管的应用.

Clinical research on acceleration of onset time of Cisatracurium in general anesthesia induction

【Objective】 To compare the onset time of co-administration of 3ED95(0.15 mg/kg) cisatracurium and different low doses of atracurium in general anesthesia induction with 3ED95 and 4ED95 cisatracurium respectively.So as to explore the clinical effect of drug combination for accelerating the onset time of cisatracurium.【Methods】 80 patients classified ASAⅠ～Ⅱ undergoing elective general anesthesia were randomly divided into 4 groups(n =20): group A received cisatracurium 0.15 mg/kg,group B received cisatracurium 0.20 mg/kg,group C received cisatracurium 0.15 mg/kg combined with atracurium 0.10 mg/kg,and group D received cisatracurium 0.15 mg/kg combined with atracurium 0.20 mg/kg.Neuromuscular block at adductor pollicis was monitored by a TOF-Watch SX accelerograph.Anesthesia was induced with midazolam 0.05 mg/kg,fentanyl 5 ug/kg,etomidate 0.3 mg/kg and the corresponding doses of muscle relaxants.Intubation was attempted after the first twitch height became less than 10% of baseline.The onset time(was from end of bolus injection to 100% twitch depression),intubation conditions and changes of MAP,HR,SPO2 were recorded.【Results】 There was no significant difference in intubation conditions,MAP,HR or SPO2 among the 4 groups.The onset time was significantly shorter in group C and D than in group A(P <0.05) but there was no significant difference between group B and A(P >0.05).【Conclusion】 Co-administration of 3ED95 cisatracurium and low doses of atracurium can accelerate the onset time without hemodynamic instability.Co-administration of two muscle relaxants is more effective than single usage of muscle relaxant.