顺式阿曲库铵不同给药方式对老年肌松作用的影响

目的研究顺式阿曲库铵不同给药方式对老年患者全麻时肌松作用的影响。方法60例择期全麻手术老年患者，ASAⅡ级，年龄（65～87）岁，随机分为三组：A组，顺式阿曲库铵0．15mg／kg静注诱导插管：B、C2组顺式阿曲库铵0．01mg／kg预注，3min后0．14mg／kg静注诱导。术中肌松维持A、B2组间断静注，C组持续静脉输注；记录起效时间、临床有效时间、恢复指数及顺式阿曲库铵用药量。结果A组起效时间大于B、C2组（P〈0．05），A、B2组临床有效时间大于C组（P〈0．05），C组平均用药量大于A、B2组（P〈0．05），三组恢复指数差异无统计学意义。结论顺式阿曲库铵诱导插管时预给小剂量可明显缩短起效时间；持续静脉输注肌松效果好、顺式阿曲库铵诱导插管时预给小剂量可明显缩短起效时间；持续静脉输注肌松效果好、停药后恢复快。

Comparison of Muscular Relaxation Effects of Cisatracurium by Different Intravenous Methods in Old Patients

Objective To study the effects of different administration of cisatracurium on neuromuscular blockade in old patients. Methods Sixty patients （ASA） aged 65 - 87 undergoing general anesthesia were randomly divided into three groups （n = 20）. Patients were performed with 0.9% sodium chloride injection by 0.15 mg/kg eisatracurium after 3 min by intravenous injection （group A） or a priming dose of 0.01 mg/kg cisatracurium followed by 0. 14 mg/kg 3 min later by intravenous injection （ group B and C） , and then patients received intermittent dose of 0.03 mg/kg cisatracurium when needed or received 3 μg/kg. min cisatracurium. Neuromuscular blocking effects were monitored with an accelerometer. Results The onset time in group B and C were shorter than those in group A （P 〈 0.05）. The clinical duration in group A and B was longer than those in group C （P 〈 0.05）. There was no significant difference on recovery index among three groups. Conclusion Old patients injected by intravenous a drop dose priming cisatracurium can significantly shorten the onset time, and the continuing infusion can implement rapid onset and fast recovery.