地尔硫对维库溴铵肌松时效的影响

Effect of diltiazem on the time-response relationship of vecuronium

目的:探讨地尔硫对维库溴铵肌松时效的影响。方法:30例ASAⅠ～Ⅱ级择期手术的全麻患者,随机分为3组,每组10例。3组患者均行静脉快速诱导气管内插管,Ⅰ组静注芬太尼5μg/kg,异丙酚2mg/kg,和维库溴铵0.1mg/kg(2×ED95)诱导,气管插管;Ⅱ组先缓慢静注地尔硫0.05mg/kg,3min后静注与Ⅰ组同等剂量的诱导用药,气管插管。Ⅲ组先缓慢静注地尔硫0.1mg/kg,3min后静注与Ⅰ组同等剂量的诱导用药,气管插管。Ⅱ、Ⅲ组中,静注地尔硫3min后收缩压下降15%以上的病例不纳入研究,每组各选10例参与研究。3组均以异丙酚维持麻醉,用Biometer加速度仪监测肌松情况。结果:Ⅰ组的无反应期为(26.5±5.5)min,Ⅱ、Ⅲ组的无反应期分别为(35.2±4.2)min和(36.4±7.2)min,Ⅱ、Ⅲ组明显延长于Ⅰ组(P<0.01),而Ⅱ组与Ⅲ组间无统计学差异;Ⅰ组的临床作用时间为(37.4±5.8)min,Ⅱ、Ⅲ组的临床作用时间分别为(48.5±4.4)min和(54.5±8.9)min,Ⅱ、Ⅲ组显著长于Ⅰ组(P<0.01),Ⅱ组短于Ⅲ组,但无统计学意义;起效时间与恢复指数各组间无统计学差异。结论:地尔硫能延长维库溴铵的无反应期与临床作用时间。

Objective： To investigate the effect of diltiazem on the time-response relationship of vecuronium. Methods： Thirty ASA grade Ⅰ-Ⅱ patients undergoing elective surgical operations were randomly allocated to three groups. A single dose of vecuronium was intravenously administered at twice ED95 （0.1 mg/kg） in group Ⅰ , combined with diltiazem 0.05 mg/kg in group Ⅱ, and combined with dihiazem 0.1 mg/kg in group Ⅲ. Anaesthesia was maintained with propofol in all groups. Neuromuscular function was monitored with Biometer accelerograph. Results- Clinical durations was 37.4 min in group Ⅰ , shorter than those in group Ⅱ （48.5 min） and group Ⅲ （54.5 min,P 〈 0.01 ;The maximum blockade period was also shorter in group Ⅰ （26.5 min） than those in group Ⅱ （35.2 min） and in group Ⅲ （36.4 min,P 〈 0.01）. Conclusion： Diltiazem can prolong the maximum blockade period and clinical duration of vecurorium.