缩短顺阿曲库铵起效时间的临床研究

目的研究预注法及限时法能否缩短顺阿曲库铵的起效时间。方法60例患者随机等分为Ⅰ组、Ⅱ组和Ⅲ组，三组诱导药均为芬太尼4μg／kg，丙泊酚2mg／kg。Ⅰ组在注入诱导药前先注入顺阿曲库铵20μg／kg，3分钟后依次注入诱导药和顺阿曲库铵80μg／kg；Ⅱ组在注入诱导药前先注入顺阿曲库铵100μg／kg，90秒后注入诱导药；Ⅲ组依次注入诱导药和顺阿曲库铵100μg／kg。用TOF-Watch监测拇内收肌神经肌肉传导功能，在肌颤搐抑制达90％时行气管插管，术中观察诱导前T1百分比，肌颤搐达90％的时间，100％抑制的时间及气管插管评级情况。结果Ⅲ组与Ⅰ、Ⅱ组比较，诱导前无T1抑制、达90％及100抑制时间均延长；患者一般情况、气管插管评级三组相近。结论预注法及限时法均能缩短顺阿曲库铵的起效时间，且两种方法所得效果无明显差异。

A Clinical Study On Shortening the Onset Time of Cisatracurium

Objective To study the effect of the priming principle and the timing principle on the onset time of cisatraeurium. Methods sixty female patients, scheduled for selective surgery under general anesthesia, were randomly divided into three groups with 20 each. All groups were induced with fentanyl 4μg/kg, propofol 2mg/kg. patients in group Ⅰ received cisatracurium 20μg/kg 3min before induction and eisatracuriurn 80btg/kg. patients in group2 received cisatracurium 100μg/kg 90see before the induction,group3 were given the induction and cisatracurium in turn. The course of depression of twitch response of the adductor pollicis muscle were recorded and intubating conditions were assessed according to a grading scale,intubation was accomplished after the first twitch was depressed 90%. Results there were not significantly different in intubating conditions among the three groups. Twitch depression of T1 at the time of intubation , the time of twitch depression to 90%and 100% in group3 is significantly smaller than that in the others. Conclusion Both the priming principle and the timing principle could reduce the onset time of cisatracurium. There were not significant different between the effect of priming principle and that of the timing principle.