顺式阿曲库铵对血流动力学及组胺释放的影响

目的在全麻诱导期间观察单次静注顺式阿曲库铵后的组胺释放作用及其对血流动力学的影响。方法ASAI～Ⅱ级全麻择期手术患者30例，随机分为顺式阿曲库铵组（Cis组）和阿曲库铵组（Atr组），两组分别单次静注Cis0．15mg／kg和Atr0．75mg／kg。麻醉诱导及维持应用瑞芬太尼和丙泊酚。采用酶联免疫吸附法测定静注全麻药前、静注全麻药后2min及静注肌松药后2min、5min的血浆组胺浓度。同时记录相应的平均动脉压（MAP）和心率（HR），观察两组在注入肌松药前后的皮肤变化情况。结果Cis组血浆组胺浓度在静注顺式阿曲库铵后无明显变化，Atr组在静注阿曲库铵后血浆组胺浓度显著升高（P〈0．05）；两组在麻醉诱导后MAP比诱导前有显著降低（P〈0．05），HR无显著变化；两组皮肤在静注肌松药前后均未发现明显改变。结论作为新型的肌肉松弛药，顺式阿曲库铵可以安全地应用于临床全麻诱导。

Hemodynamic changes and histamine release caused by cisatracurium

Objective To evaluate and compare the histamine release and hemodynamic changes caused by cisatracurium and atracurium during induction of general anesthesia. Methods 30 ASA Ⅰ - Ⅱ patients undergoing elective surgery were randomly divided into 2 groups in which patients received a single bolus of either cisatracurium 0.15 mg/kg or atracuriam 0. 75 mg/kg. Anesthesia was induced and maintained with remifentanil and propofol. Blood samples were obtained before anesthesia, 2 min after the administration of remifentanil and propofol, and at 2 and 5 min after the administration of relaxant for determination of plasma histamine concentrations using enzyme linked immunosorbent assay. The hemodynamic data and the changes of skin were also recorded. Results The plasma histamine concentrations were not significantly different in cisatracurium groups （ P 〉 0.05 ）. After a single bolus of atracurium 0.75 mg/ kg, the plasma histamine concentrations significantly increased （ P 〈 0.05 ）. MAP decreased significantly after induction than before in both groups （ P 〈 0.05 ）. There were not any significant changes in HR and the skin in both groups. Conclusions Cisatracurium, a new potent muscle relaxant, can be safely used for induction of general anesthesia.