丙泊酚靶控输注或异氟醚吸入对罗库溴铵药效学的影响

The effects of propofol TCI or isoflurane inhalation on rocuronium pharmacodynamics

目的 探讨丙泊酚靶控输注和异氟醚吸入对罗库溴铵药效学的影响。方法 选择无神经肌肉疾患 ,在全麻下择期手术的病人 4 8例 ,随机分成丙泊酚靶控输注组 (B组 )和异氟醚吸入组(Y组 )维持麻醉。采用TOF刺激方式监测拇内收肌的收缩反应。当T1恢复至对照值的 2 0 %时追加罗库溴铵 0 15mg/kg。记录每次追加罗库溴铵的间隔时间以及肌松恢复情况。 结果 两组肌松维持时间无明显差异 (P >0 0 5 ) ,而B组罗库溴铵总用药量明显高于Y组 (P <0 0 5 )。B组各次追加罗库溴铵间隔时间平均为 (2 6 1± 9 3)s,Y组平均间隔时间为 (36 2± 13 2 )s,明显比B组长 (P<0 0 5 )。Y组第 1、2次给药后的间隔时间相似 (P >0 0 5 ) ,第 3、4、5次给药后间隔时间也相似 (P <0 0 5 ) ,但是比第 1、2次延长 (P <0 0 5 )。Y组T1恢复到对照值的 2 5 %、5 0 %和 75 %的时间及拔管时间比B组长 (P <0 0 5 ) ,但两组的恢复指数相似 (P >0 0 5 )。结论 丙泊酚靶控输注对罗库溴铵的药效学没有影响。而异氟醚对罗库溴铵则起增效作用 ,异氟醚维持麻醉时应酌情减少罗库溴铵的用量。

Objective To study the effects of propofol TCI or isoflurane inhalation on rocuronium pharmacodynamincs.Methods Forty-eight patients without neuromuscular disease undergoing selective operation were randomly divided into propofol target control infusion(TCI)group(group B)and isoflurane inhalation group(group Y).Thumb adductorius contractile response was monitored with TOF stimulation.When T 1 recovering 20% of control value,rocuronium 0.15 mg/kg was intravenously injected.The interval of rocuronium injection and the recovery of muscle relaxation were recorded.Results There was no significant difference between two groups in the duration of muscle relaxation (P>0.05),but total amount of rocuronium in group B was higher than that of group Y(P<0.05).The interval of rocuronium injection in group B averaged (26.1±9.3) s,which was significantly shorter than that in group Y(36.2±13.2) s(P<0.05).In group Y,the first and second intervals of rocuronium injection were similar(P>0.05),the third,fourth and fifth intervals of that were also similar(P>0.05),but longer than those of the first and second interval(P<0.05).The time of T 1 recovering 20%,50% and 75% of the control value and extubation time were longer in group Y than those in group B(P<0.05),but the recovery index between the two groups was not significantly different(P>0.05).Conclusion Propofol TCI has no effects on rocuronium pharmacodynamics.Isofluran inhalation augments the effect of rocuronium and the dose of rocuronium should be decreased during isofluran anesthesia.