胸科手术中丙泊酚-七氟烷静吸复合麻醉对顺式阿曲库铵肌松效应的影响

目的观察丙泊酚-七氟烷静吸复合麻醉在胸科手术中对顺式阿曲库铵肌松效应的影响。方法选择择期胸科手术（包括肺叶切除和食管癌切除术）64例患者,ASAⅠ或Ⅱ级,年龄46~72岁,随机分为丙泊酚-七氟烷静吸复合麻醉组32例（七氟烷组）和丙泊酚-芬太尼静脉麻醉组32例（对照组）。麻醉期间监测有创桡动脉血压,心率和脑电双频指数（BIS）,使BIS维持在40~60,使用加速度肌松监测仪刺激前臂尺神经,观察拇内收肌的收缩反应,记录顺式阿曲库铵的起效时间、无反应时间、肌松维持时间以及恢复指数等指标。结果所有患者术中生命体征平稳,顺式阿曲库铵的起效时间、无反应时间以及T125%时间差异无统计学意义,但七氟烷组25%四个成串刺激（TOFr）恢复时间、恢复指数以及拔管时间明显延长（P〈0.05）。结论七氟烷明显增强顺式阿曲库铵肌松作用。

The Effects of propofol and sevoflurane on pharmacodynamics of cisatracurium during thoraces surgery

Objective To observe the effects of propofol and the neuromuscular block of cisatracurium during thoraces surgery.Methods Sixty cases ASA class Ⅰ or Ⅱ patients aged 48~76 years of thoraces procedures（pneumonectomy and radical operation of esophagical carcinoma） were randomly divided into two groups： sevoflurane with propofol and Fentanyl combined with propol.Continous blood pressure was gained through radial artery cannulization,changes of HR and BIS.The TOF mode of stimulation was used to monitor neuromuscular blocking variables of onset time,no-response time,the time of T1 25% recovery,recovery index and the TOF ratio（TOFr） to 25%.Results All case experienced stable vital signs during surgical procedures.TOFr0.25 and recovery index were greater in sevoflurane group than those in propofol group（P0.05）.But there were no significant differences in the onset time,no-response time,and T1 25% recovery time between two groups.Conclusion Sevoflurane inhalation can significantly enhance the neuromuscular block of cisatracurium.