七氟醚或异氟醚对罗库溴铵药效学的影响

The effects of sevoflurane and isoflurane on pharmacodynamics of Rocuronium

目的观察吸入1%的七氟醚或等效浓度的异氟醚对罗库溴铵临床药效的影响。方法选择无神经肌肉疾患,在全麻下行择期手术的病人45例,随机分成异丙酚—N_2O组(A组),七氯醚—N_2O组(B组)和异氟醚—N_2O(C组)。采用TOF刺激方式监测拇内收肌的收缩反应。罗库溴铵的诱导剂量为0．6mg·kg^(-1)。当T_1恢复至对照值的25%时开始静滴罗库溴铵,记录罗库溴铵的起效时间,临床作用时间(T_(25)),维持T_1在1%～10%所需罗库溴铵的输注速度及恢复指数(T_(25)～T_(75))。结果A、B和C组的起效时间分别是89．1±17．2秒、84．5±15．6秒和87．7±16．0秒(P＞0．05)；作用时间分别是34．2±12．4 min、45．6±14．6 min和43．4±13．1 min(P＜0．05),维持90%～99%颤搐抑制所需罗库溴铵的输注速度分别为6．71±1．83μg．kg^(-1)·min^(-1)、4．87±1．43μg·kg^(-1)·min^(-1)和5．43±1．63μg·kg^(-1)min^(-1)(P＜0．01)；恢复指数分别为10．8±4．2 min、14．6±4．8 min和16．2±5．3 min。结论1%的七氟醚及等效浓度的异氟醚均可增强罗库溴铵的临床药效,但二者之间的增强效应无显著差异。

Objective ：To observe the effects of 1% sevoflurane and equivalent isoflurane on pharmacedynamics of rocuronium. Methods ： Forty-five ASA Ⅰ - Ⅱ patients without any neuromuscular disease undergoing elective surgery under general anesthesia were randomly divided into three groups of 15 patients each. In group A, the anesthesia was maintained by continuous propofol and inhaling 67% N20 ,in group B by inhaling 1.0% sevoflurane-67% N2O and in group C by 0.7% isoflurane-67% N2O. Thumb adductorius contractile response was monitored with TOF stimulation when T1 recovering 25% of control value, 0.04% rocumnium was intravenously infused. Results： Onset times of rocuronium in three groups were 89.1 ± 17.2 s, 84. 5 ± 15.6 s and 87. 7 ± 16.0 s （P 〉 0. 05 ）. Clinical duration in group Band C was longer than that in group A （45.6 ± 14.6 min, 43.4 ± 13.1 min and 34. 2 ± 12.4 min P 〈0. 01 ）. The infusion rates of rocuronium to maintain 90% -99% blockade in three groups were 6.71 ± 1.83 μg·kg^-1·min^-1 , 4. 87 ± 1.43 μg·kg^-1·min^-1 and 5.43 ± 1.63 μg·kg^-1·min^-1 （P 〈0. 01 ） , and recovery index in three groups were 10. 8 ±4. 2 min, 14. 6 ±4. 8 min and 16.2 ±5.3 min （P 〈 O. 01）. Conclusion： It is suggested that 1.0% sevoflurane and equipotant isoflurane can potentiate the muscular relaxation action of rocuronium.