颅脑外科手术中过度通气对罗库溴铵肌松时效的影响

目的:研究过度通气对罗库溴铵肌松时效的影响。方法:选择无神经肌肉疾患、ASAI-Ⅱ级、择期行颅脑外科手术患者40例,随机分成对照组(A组,n=20)和过度通气组(B组,n=20)。术中控制呼吸,维持PaCO2分别大于(A组)或小于(B组)35mmHg。用加速度仪监测拇内收肌收缩反应,观察两组罗库溴铵0.6mg/kg的肌松时效差异。结果:A、B两组起效时间分别为1.26±0.31min和1.18±0.37min,无显著差异;临床时效分别为37.4±7.1min和30.3±6.5min,P<0.05,恢复指数分别为10.4±1.9min和9.2±2.1min,无显著差异。结论:过度通气可使罗库溴铵临床时效缩短,但起效时间和恢复指数无明显差异。

Effect of Hyperventilation on the Time-Effect of Rocuronium in Neurosurgery

Objective To study the effect of hyperventilation on the time-effect of rocuronium in neurosurgery.Methods The Twenty patients,ASAgrade I-Ⅱ,undergoing neurosurgery were randomly divided into two groups,control group(A,n=20)and hyperventilation group(B,n=20).PaCO2 was kept>35mmHg or<35mmHg by controlled respiration during surgery.The neuromuscular with the percentage depression of T1 response serving as the parameter,the time-response difference of 0.6mg/kg recuronium between the two groups was determined.Results The effective times of group A and B(from infusion to T1=0)were 1.26±0.31 min and 1.18±0.37 min respectively.The clinical effective time(from infusion to T1=25%)were 37.4±7.1min and 30.3±6.5min respectively(P<0.05).The recovery indexes(from T1=25%～75%)were 10.4±1.9min and 9.2±2.1min respectively.Conclusion Hyperventilation with PaCO2 less than 35mmHg can shorten the clinical effective time of rocuronium without any remarkable changes in the onset time and recovery.