顺式阿曲库铵在新生儿食管裂孔疝修补术中的应用

目的:探讨顺式阿曲库铵应用于新生儿的药效学特点。方法:择期行食管裂孔疝修补术的新生儿60例,于5s内单次静脉注入2ED95(Ⅰ组)或3ED95(Ⅱ组)的顺式阿曲库铵,每组30例。120s后行气管插管,记录拇内收肌肌颤搐高度并对插管条件进行评级。观察阻滞起效时间、TOF无反应期、阻滞维持时间、肌松恢复指数与体内作用时间。结果:Ⅱ组气管插管时肌松阻滞和插管条件明显优于Ⅰ组(P<0.05),肌松起效时间Ⅱ组显著短于Ⅰ组(P<0.01),TOF无反应期、阻滞维持时间和体内作用时间Ⅱ组明显长于Ⅰ组(P<0.05),但肌松恢复指数2组比较无显著性差异(P>0.05)。结论:3ED95诱导剂量应用于新生儿安全、有效,起效快且气管插管条件较2ED95佳。虽然3ED95的顺式阿曲库铵的TOF无反应期、阻滞维持时间和体内作用时间均较2ED95的时间长,但2组剂量恢复指数无明显差异。

Application of Cisatracurium in Hiatal Hernia Repair of Newborn

OBJECTIVE: Approach to the pharmacodynamics of cisatracurium in newborn. METHODS: Sixty patients were randomized to two groups: Group Ⅰ and Group Ⅱ , received( iv) 2ED95 or 3ED95 cisatracurium in 5 seconds respectively, n=30. Neuromuscular transmission was monitored and Intubation conditions were assessed at 120s after cisatracurium administration using a 4- part scale. Observe onset time, TOF no reaction period, duration of action, recovery index, duration in vivo. RESULTS: The muscular blockage and conditions of intubation after 120s were different between two groups( P<0. 05) . The onset time in Group Ⅱ were significantly shorter than in GroupⅠ ( P<0. 01) , TOF no reaction period, duration of action and duration in vivo were significantly longer than in Group Ⅰ ( P<0. 05) . However, there was no significantly recovery index in two groups( P>0. 05) . CONCLUSIONS: 3ED95 cisatracurium produces quicker, safer onset time and acceptable intubating conditions in the great majority of newborn than 2ED95. The TOF no reaction period, duration of action and duration in vivo were longer in 3ED95 group than in 2ED95 group, but recovery index are no significant between 2 groups with dosage.