异氟醚对老年患者顺式阿曲库铵肌肉松弛效应的影响

目的 观察异氟醚对老年患者顺式阿曲库铵肌肉松弛效应的影响.方法 60 例美国麻醉医师协会Ⅱ级行择期手术的老年患者,随机数字表法分为两组,每组30例.丙泊酚组持续输注丙泊酚4～6 mg/（kg·h）,依据需要静注芬太尼维持麻醉;异氟醚组1.0 MAC异氟醚吸入,依据需要静注芬太尼维持麻醉.记录肌松起效时间、作用时间、术中维持速率、T1 25%、75%恢复时间、TOF比值恢复到70%的时间及恢复指数.结果 异氟醚组起效时间（231.32±25.48）s]及恢复指数（14.83±3.42）min]与丙泊酚组（237.41±31.33）s、（13.07±3,74）min]差异无统计学意义,异氟醚组作用时间（42.37±5.32）min]、T1 25%、75%恢复时间（53.94±8.20）min、（70.78±7.65）min],明显长于丙泊酚组（29.46±4.73）min、（41.31±6.43）min、（55.74±6.19）min,P＜0.05],异氟醚组术中维持速率（88.32±13.25）μg/（kg·h）],明显小于丙泊酚组（115.64±17.52）μg/（kg·h）].结论 异氟醚能显著延长老年患者顺式阿曲库铵的作用时间及恢复时间,减小术中维持速率,但对恢复指数无明显影响.

Effects of isoflurane on the cisatracurium-induced neuromusular blockade in old patients

Objective To investigate the effects of 1.0 MAC isoflurane on neuromuscular blockade by cisatracurium in old patients.Methods Sixty patients(ASA Ⅱ) aged 65-88, undergoing selective surgery under gener(group Ⅰ) , 1.0 MAC isoflurane(group Ⅱ) , with continuous neuromuscular blockade by cisatracurium.Neuromuscular blocking effects were monitored with an accelerometer.All patients were given fentanyl intermittently to maintain a relatively stable hemodynamie.The onset time, clinical duration, maintenance dose and times to T1 recovered to 25%, 75% and TOF ratio 70% were noted.The recovery index (time of T1 recovers from 25% to 75%) was also calculated.Results The clinical duration of group Ⅰ and group Ⅱ were(29.46 ±4.73)min and T1 25% 75% recovery time also showed difference between two groups(P ＜ 0.05).But there was no significant difference between two groups in onset time and recovery index.Conclusion 1.0 MAC isoflurane augments and prolongs the neuromuscular block produced by eisatraeurium in old patients, but does not effect the recovery index and the infusion rates.