单次或持续静脉输入维库溴铵作用时效比较

对比观察单次、分 2次或持续静脉输注等量的维库溴铵 ( 0 .1mg/kg)维持下实际完全神经肌肉阻滞时间的差异。择期神经外科手术病人 30例 ,分成 3组 ,每组 1 0例。静注芬太尼 2 μg/kg,异丙酚 1 .5mg/kg ,维库溴铵0 .1mg/kg诱导插管后 ,以异丙酚 异氟醚静吸复合麻醉 ,用加速度仪监测拇指内收肌电刺激 收缩反应 (四连串刺激 ) ,当T1恢复到 2 %时 ,分组以不同方式给予维库溴铵 :A组 ,0 .0 5mg/kg单次静脉注入 ,待T1=2 %时再重复 1次 ;B组 ,0 .1mg/kg单次静脉注入 ;C组 ,先按 0 .1mg/ (kg·h)输入 ,待T1=0后改为 0 .0 5mg/ (kg·h)。计算实际完全阻滞时间(T1=0～ 2 %之间的时间 )。结果 :A、B、C 3组实际完全阻滞时间分别是 ( 53.0± 3.8)min、( 50 .3± 5.2 )min和( 1 0 2 .7± 5.5)min ,C组与A、B 2组相比均有显著性差异 (P <0 .0 1 )。持续静脉输入维库溴铵使神经肌肉阻滞时间延长近 1倍

Comparison of Pharmacokinetics between Bolus and Continuous Vecuronium

To compare the neuromuscular block effects of vecuronium administered by continuous infusion or bolus injection, thirty patients undergoing selective neurosurgery were randomly allocated into three groups, 10 in each group. The patients were induced with fentanyl, propofol and vecuronium, 0.1 mg/kg and intubated intratracheally. Anesthesia was maintained with propofol and isoflurane. The neuromuscular function(train-of-four, TOF)was monitored with Biometer acceleromyography. When T₁ returned to 2%,the maintaining dose of vecuronium, 0.1 mg/kg, was administrated in three ways: in group A, 0.05 mg/kg iv bolus and repeated while T₁=2% again; 0.1 mg/kg iv bolus in group B, and infused intravenously with 0.1 mg/(kg·h)and changed to 0.05 mg/(kg·h)when T₁=0. The complete block time(the time between T₁=0 and T₁=2%)was calculated. The complete block times in group A, B and C were(53.0±3.8)min,(50.3±5.2)min and(102.7±5.5)min respectively, with significant differences among the three groups(P<0.01). Continuos infusion of vecuronium can double neuromuscular block time than bolus injection.