加速度法肌松监测下T1/Tc与TOFR的相关性

The Relationship between Single Twitch Stimulation and Train-of-four Ratio in Acceleromyography during Recovery from Neuromuscular Blockade

目的:研究加速度法监测神经肌肉传递功能时单刺激肌颤搐与4个成串刺激的对应关系。方法:选择20例ASAⅠ～Ⅱ级,择期行腹式全子宫切除术患者。麻醉诱导用咪达唑仑、芬太尼和异丙酚,单次肌颤搐定标稳定后,静注维库溴铵0.1mg.kg-1气管插管。予以芬太尼、异丙酚复合吸入50%笑气维持麻醉。应用TOF-WATCHSX加速度仪(Organon公司,荷兰)刺激尺神经,记录肌松恢复期TOFR(T4/T1)及T1/Tc值。结果:当TOFR恢复到20%、40%、75%、85%时,T1/Tc为(32±8.78)%、(60±8.18)%、(90±8.14)%和(95±5.37)%。结论:加速度(AMG)法监测肌松恢复,TOFR>0.85时,T1/Tc才接近完全恢复。即AMG法下的TOFR需要达到更高值(即>0.85)时才能达到在MMG或EMG法下TOFR=0.7时的T1/Tc值。

Objective：To observe the relationship between single twitch stimulation（T1） and train-of-four ratio （TOFR） during recovery from neuromuscular blockade monitored by acceleromyography. Methods：Twenty adult patients （ASA class Ⅰ-Ⅱ ）scheduled for abdominal hysterectomy were induced with midazolam, fentanyl and propofol. After calibration with single twitch stimulation stabilized, veeuronium 0.1mg·kg^-1 was administered to facilitate tracheal intubation. Anesthesia were maintained with propofol, fentanyl and nitrous oxide. TOFR and T1/Tc were measured with the TOF- WATCH SX accelero- myography. Results： When TOFR recovered to 0. 2,0. 4,0. 75 and 0.85, T1/Tc was （32 ± 8.78）%, （60 ± 8. 18）%, （90 ± 8.14） % and （95 ± 5.37）% respectively. Conclusion：In order to reach a full recovery of neuromuscular transmission, the TO- FR over 0.85 is reasonable when monitored by acceleromyography.