罗库溴铵、维库溴铵和阿曲库铵用于全麻气管插管肌松效应的对比研究

目的观察比较罗库溴铵、维库溴铵及阿曲库铵在全麻诱导气管插管时的肌松效应及不良反应。方法ASAⅠ~Ⅱ级择期全麻下行腹腔镜胆囊切除手术患者120例,随机分为:罗库溴铵组(Ⅰ组)、维库溴铵组(Ⅱ组)、阿曲库铵组(Ⅲ组),每组给2倍ED95剂量肌松剂。Ⅰ组按用量再分为:Ⅰa组(2倍ED95,0.6 mg/kg)、Ⅰb组(3倍ED95,0.9 mg/kg)2个亚组。每组各30例。麻醉诱导依次静注咪达唑仑0.06 mg/kg、芬太尼4μg/kg,异丙酚2 mg/kg后,Ⅰa、Ⅰb组分别静注罗库溴铵0.6 mg/kg、罗库溴铵0.9 mg/kg,Ⅱ组静注维库溴铵0.15 mg/kg,Ⅲ组静注阿曲库铵0.5 mg/kg。观察各组气管插管时的肌松效果及不良反应。结果Ⅰ组的起效时间及插管状态优良率均明显高于Ⅱ、Ⅲ组,Ⅰb组的插管条件好于Ⅰa组。Ⅰ组的支气管痉挛、皮疹等不良反应的发生率明显低于其他组,对循环系统的影响也较小。结论罗库溴铵比维库溴铵、阿曲库铵起效快,恢复迅速,不良反应少,是较好的全麻气管插管肌松药。

Comparison of neuromuscular blockade effects of rocuronium, vecuronium and atracurium on rapid endotracheal intubation

Objective To compare the neuromuscular blockade effect and side effect of rocuronium,vecuronium and atracurium on rapid endotracheal intubation.Methods One hundred and twenty patients were randomized to four groups(n=30):Ⅰa group(rocuronium,0.6 mg/kg),Ⅰb group(rocuronium,0.9 mg/kg),Ⅱ group(vecuronium,0.1 mg/kg),Ⅲ group(atracurium,0.5 mg/kg).All patients were anesthetized with intravenously injection of midazolam(0.06 mg/kg),fentanyl(4 μg/kg),propofol(2 mg/kg) and muscular relaxants.Then the neuromuscular blockade and side effects of groups were observed.Results The onset and recovery time of Ⅰ group were shorter than other groups significantly.The intubation situation of Ⅰ group was better,and the side effects were less than Ⅱ and Ⅲ groups.Conclusion Compared with vecuronium and atracurium,rocuronium is quick in onset and recovery,and has little side effect.It is a good relaxant for rapid endotracheal intubation.