比较维库溴铵在青年和中年女性患者全麻中的肌松效应

目的 观察并比较维库溴铵在青年和中年女性患者全麻中肌松效应的影响. 方法 将40例按美国麻醉医师协会（ASA）分级标准定为Ⅰ～Ⅱ级的乳腺包块手术女性患者分为青年组（18岁～44岁）和中年组（45岁～59岁）,每组20例.麻醉诱导期间给予2 ED95 0.1 mg/kg维库溴铵,用TOF-Watch加速度仪进行肌肉松弛监测,采用四个成串刺激（train of four,TOF）方式监测拇内收肌的收缩反应.观察起效时间、时效、体内作用时间、恢复指数、TOF比率恢复到25％的时间. 结果 青年组肌松起效时间、体内作用时间及TOF恢复到25％的时间均明显短于中年组（156±33）、（186±44）s、（67±29）、（77±20）、（48±14）、（60±16） min] （P＜0.05）.两组时效（37±10）、（43±11）min]、恢复指数（21±17）、（22±13） min]差异无统计学意义（P＞0.05）.结论 与中年女性患者比较,青年女性患者对维库溴铵较敏感,起效快,体内作用时间短,但对肌松恢复过程无影响.

Comparision of the neuromuscular effects of vecuronium in young and middle-age female patient during general anesthesia

Objective To observe and compare the neuromuscular effects of vecuronium in young and middle-age female patient during general anesthesia.Methods A total of 40 ASA Ⅰ-Ⅱ female patients scheduled for breast mass excision were randomly assigned to two groups：young-age group 18-44 years old and middle-age group 45years old-59 years old,with 20 patients each.Vecuronium of 2 ED95 （0.1 mg/kg） was injected during anesthesia induction,using TOF-Watch acceleration monitoring instrument for muscle relaxation.Thumb adductorius contractile response was monitored with train of four（TOF） stimulation.The time of neuromuscular block onset,duration of blockade maintenance,duration of in vivo action,recovery index and the time of TOF ration of recovery to 25％ were recorded.Results The muscle relaxant onset time,duration of action in vivo and TOF recovery to 25％ of the time in youth group were significantly shorter than that in the middle-aged group （156±33）,（186±44） s,（67±29）,（77±20）,（48± 14）,（60±16） min] （P＜0.05）.There were on significant difference in duration of blockade maintenance （37± 10）,（43± 11） min] （P＞0.05）and neuromuscular block recover index （21±17）,（22±13） min]（P＞0.05）between two groups.Conclusions Compared to patients with middle-aged women,young female patient showed more sensitive to vecuronium with faster neuromuscular block onset,shorter duration of clinical action,but had no effect on the recovery process of muscle relaxants.