七氟醚、异氟醚对罗库溴铵强化作用的时效关系研究

The time course of potentiation of rocuronium by sevoflurane versus isoflurane

目的观察1MAC七氟醚或异氟醚对罗库溴铵强化作用的时效关系。方法54例择期全麻男性病人在咪唑安定一芬太尼一异丙酚麻醉期间持续输注罗库溴铵,维持95%的肌松,稳定后,病人随机分成静脉麻醉组、七氟醚组或异氟醚组,调整罗库溴铵的注入速率,维持95%的肌松,观察吸入七氟醚或异氟醚后罗库溴铵的注入速率随时间变化的趋势。结果七氟醚、异氟醚都显著降低了罗库溴铵的注入速率,此效应随吸人七氟醚或异氟醚时间的延长逐渐增加,吸入七氟醚或异氟醚90 min后达最大效应即罗库溴铵的注入速率下降到最大值。最大下降率:七氟醚组为44.3%,异氟醚组为38.9%。结论七氟醚、异氟醚明显增强罗库溴铵的肌松作用,其程度相近,且这种强化作用有显著的时间依赖性。

Objective： To investigate the time course of potentiation of rocuronium produced byl MAC of sevoflurane or isoflurane. Methods ： Fifty - four ASA Ⅰ-Ⅱ male patients aged 18 - 60 years undergoing elective abdominal operation under general anesthesia were studied. Anesthesia was induced with midazolam 0. 1 mg · kg^-1, fentanyl 4ug · kg^-1 and propofol 2 - 4mg · kg^ - 1. Tracheal intubation was facilitated with rocuronium 0.6 mg · kg ^-1 iv. The degree of neuromuscular block was monitored by measuring muscle response to TOF using accelerography （ HXD- I ）. For maintenance of anesthesia the patients were randomly assigned to receive either propofol ＋ fentanyl （ Control group ） or 1 MAC of sevoflurane （ Sevo group） or t MAC of isoflurane （Iso group）. Rocuronium was continuously infused during operation to maintain T1 at 5% of the control and the infusion rate was recorded eve 15 min. Results： In Sevo and Iso groups the infusion rate of rocuronium was reduced in an exponential manner and maximal potentiation occurred at 90 min of isoflurane or sevoflurane inhalation. The maximal reduction in infusion rate was 44.3% in Sev group and 38.9% in Iso group. There was no significant difference between the two groups. Conclusions： Sevoflurane and isoflurane can potentiate the muscle relaxation produced by rocuronium in a similar degree and the potentiation is time dependent.