七氟烷对罗库溴铵、维库溴铵及阿曲库铵临床药效的影响

目的 以丙泊酚为对照,观察1.3 MAC的七氟烷对罗库溴铵、维库溴铵及阿曲库铵临床药效的影响.方法 选择60例择期腹部手术的病人随机分为6组,每组10人.七氟烷罗库溴铵组(sR组)、七氟烷维库溴铵组(SV组)及七氟烷阿曲库铵组(SA组)分别吸入1.3 MAC的七氟烷及静注芬太尼维持麻醉,丙泊酚罗库溴铵组(CR组)、丙泊酚维库溴铵组(CV组)及丙泊酚阿曲库铵组(CA组)以丙泊酚6 mg·kg-1·h-1～8 mg·kg～·h-1及芬太尼维持麻醉.监测起效时间、最大抑制程度、作用时间、维持速率、恢复时间、恢复指数.结果 七氟烷组与相应的对照组在最大抑制程度、恢复指数方面的无统计学差异,起效时间、作用时间、维持速率、恢复时间有统计学差异.结论 七氟烷能明显延长罗库溴铵、维库溴铵以及阿曲库铵的作用时间和恢复时间并减少其起效时间、维持剂量,但对最大抑制程度和恢复指数则无明显影响.     

Monitoring of neuromuscular block

The first 150 words of the full text of this article appear below. Key points Postoperative residual curarization occurs evenafter administration of intermediate-acting non-depolarizingneuromuscular blocking drugs, for example, atracurium or vecuronium. Satisfactoryrecovery from neuromuscular block has not occured until thetrain-of-four ratio is >0.9. Quantitative methods of measuringevoked responses, for the example, acceleromyography or mechanomyography,are necessary to ensure adequate recovery from block. Onsetand recovery from neuromuscular block occurs at different ratesin different muscles. Anticholinesterases should not be usedto antagonize residual neuromuscular block unless full recoveryhas been demonstrated.   There is increasing evidence that residual neuromuscular blockis common, and also that it may adversely affect patient outcome.A study by Debaene and colleagues¹ found that 45% of patientshad residual curarization (train-of-four [TOF] ratio<0.9)in the postoperative recovery room after a single intubatingdose of the intermediate-acting drugs atracurium, vecuroniumor rocuronium. Another study found residual curarization (TOFratio<0.7) in 42% of patients in the . . . [Full Text of this Article]