不同静脉和吸入麻醉药对罗库溴铵肌肉松弛作用的影响

Rocuronium induced neuromuscular blockade during various intravenous or volatile anesthesia

目的：研究不同静脉和吸入麻醉药对罗库溴铵肌肉松弛作用的影响。方法：５０例病人分为５组，观察并比较了静脉麻醉药咪唑安定、异丙酚和吸入麻醉药（１．２ＭＡＣ）安氟醚、异氟醚和七氟醚对罗库溴铵肌肉松弛作用的影响，以及罗库溴铵对血流动力学的影响。结果：肌松作用起效时间５组间无显著差异，平均为４４．５～４９．１秒。其临床维持时间、７５％恢复时间和恢复指数三种吸入麻醉药组均显著长于两种静脉麻醉药组（Ｐ＜０．０１），而三种吸入麻醉药组间和两种静脉麻醉药组间则无显著差异。咪唑安定组和异丙酚组的肌松作用临床维持时间平均为３６．２～４１．５分钟。罗库溴铵静脉给药后血压、心率维持平稳。结论：罗库溴铵具有起效快、中等作用维持时间和血流动力学稳定的特点，但与高浓度吸入麻醉药合用可使其作用时间明显延长。

Objective:We determined the effects of various intravenous or volatile anesthetics on the rocuronium induced neuromuscular blockade and observed the cardiovascular effects of rocuronium Methods:Fifty patients were randomly allocated to five groups(n=10) who were anesthetized with intravenous midazolam or propofol,or inhalation(1 2MAC) of enflurane,isoflurane or sevoflurane,respectively.Acceleration of thumb adduction in response to single or train of four stimulation of the ulnar nerve was quantified.Rocuronium 0 6mg/kg(2×ED 95 ) was given intravenously.Results:The onset time of neuromuscular blockade of rocuronium were similar among the five groups,with the average time from 44 5 to 49 1 seconds.While the clinical duration,the 75% recovery time and the recovery indexes in the three volatile anesthetics groups were significantly longer than those in the two intravenous groups(P<0 01).There were no significant differences in the above parameters among the three volatile groups and between the two intravenous groups.The average clinical durations in the two intravenous groups were between 36 2 and 41 5 minutes.Blood pressure and heart rate were stable after intravenous rocuronium.Conclusions:Rocuronium has a short onset time and an intermediate duration of action and has no effects on the cardiovascular system.Its duration of action is significantly prolonged by high concentrations of volatile anesthetics.