缩短维库溴铵起效时间的研究

Study of Shortening Onset Time of Vencuronium Treacheal Intubation

全麻插管手术２０例，应用维库溴铵分预注法和大剂量法，各１０例，作快速诱导气管插管，后者插管量固定为８ｍｇ，不再以体重计算，用国产加速度仪监测其起效时间（Ｔ１降为５％）、有效时间（Ｔ１恢复到２５％）、肌松程度（ＰＴＣ）和插管条件、心血管反应。结果：ｐＤ０．０１ｍｇ／ｋｇ、ｐＴ４ｍｉｎ、ＩＤ０．０９ｍｇ／ｋｇ作预注插管可明显缩短起效时间（９８±１０．３２ｓ），且小于大剂量法（１１２±１１．３ｓ）（ｐ＜０．０１），肌松程度和有效作用时间也小／短于大剂量法（５±１．３８次／１．８±０．５次，２９．４±４．１２ｍｉｎ／５０．２±５．４ｍｈ）（Ｐ＜０．０１）。两组插管优良率、心血管反应及ＳｐＯ２的变化无显著性差异（Ｐ＞０．０５）。因此，本研究大剂量法组虽起效稍慢，但操作方便，肌松满意，维时长，可供临床选择应用。

he onset time of vencuronium was studied in 20 surgical patients under general anesthesia. A priming dose(PD)of vencuronium,0. 001mg/kg,wa;given 4min before an intubation dose(ID)of it,0.09mg/kg,in 10 cases(group A).Abolus injection of vencuronium, 8mg,was administered in another 10 patients(group B).The onsettime(T1 of TOF was depressed by 95%)and the effective action duration(T1 of TOF returned to 25%of the baseline)were measured with accelograph in all patients.The results show that the onset time of ID vencuronium ingroup A was 98±10.32s,which is significantly shorter than that of bolus injection in group B(112±11.3s)(P<0.01).The effective action duration of ID vencuronium in group A was 29.4±4.12min,which is remarkablv lessthan that of bolus injection in group B(50.2±5.4min)(P<0.01).More profound neuromuscular bIockade wasrecorded in group B than than in group A.There was no any significant difference in the condition for intubation,cardiovascular side effect and SpO2 between group A and B. It is concluded that the onset time of ID vencuroniumcan be shortened by a priming injection technic. Abolus inlection of vencuronium,however,is easv to do and has alonger neuromuscular blockade.