术中保温对持续输注顺式阿曲库铵代谢的影响

目的:观察患者术中保温对顺式阿曲库铵代谢过程的影响。方法:选择ASA(Ⅰ～Ⅱ)级行择期手术的患者24例,随机分为两组,Ⅰ组为对照组,Ⅱ组为术中保温组。Ⅱ组术中用保温毯保温,术中冲洗用盐水加温至37℃,用输液加温器加温输注液体,Ⅰ组对照组不做上述保温处理。选用四个成串刺激方式监测尺神经-拇内收肌神经传递功能,TOF频率为2Hz,串间间隔15s,刺激电流为50mA,当T1值恢复至10%时持续静脉泵注顺式阿曲库铵,并调节微泵速度,维持T1 10%,至缝合肌层后停止泵注,并记录顺式阿曲库铵的泵注量,T1恢复至25%、75%,TOF 90%的时间和患者的食道温度。结果:两组患者年龄、性别比例、体重差异及顺式阿曲库铵用量的差异均无统计学意义(P>0.05),Ⅰ组患者手术结束时的体温在36℃以下,Ⅱ组患者手术结束时体温在36℃以上。与Ⅰ组患者比较,Ⅱ组患者的肌松恢复时间明显缩短,差异有统计学意义(P<0.05)。结论:手术中对患者进行保温对于药物的代谢消除,减少药物残留造成围术期并发症有着重要的意义。

Effect of intraoperative insulation on Metabolism of Continuous infusion of Cisatracurium

objective:To observe the effect of intraoperative insulation on the metabolic process of cisatracurium in general anesthesia.Methods:24 patients undergoing elective surgery and according with ASA grade(Ⅰ~Ⅱ)were randomLy divided into group Ⅰ served as controlled group free warming,and group Ⅱ accepted intraoperative heat preservation by fluid warming device and using 37℃ warming blanket.The neurotransmission function of ulnar nerve and thumb adductor were monitored with TOF frequency for 2 Hz,strung interval of 15s,the stimulus current for 50mA.Cisatracurium was continuously injected by pump when T1 value reached to 10% and regulated T1 to 10% until muscle suture,and record the amount of cisatracurium.Results:Body temperature was 36 ℃ bellower in group i but 36 ℃ higher for group Ⅱ at end of operation.There was no statistical difference in age,sex ratio,weight and amount of cisatracurium between the two groups(P>0.05).Muscular relaxation recovery time was significantly shortened in group Ⅱ as compared with group I(P<0.05).Conclusions:Intraoperative insulation plays an important role in reduction of perioperative complications resulted from drug residue and pharmacokinetics.