急性高容量血液稀释对全麻患者维库溴铵肌松起效和恢复的影响

Effect of acute hypervolemic hemodilution on the onset and recovery of muscle relaxation induced by vecuronium

目的 探讨急性高容量血液稀释（AHHD）对全麻患者维库溴铵肌松起效和恢复的影响。方法 择期全麻下普通外科手术患者32例，ASAⅠ或Ⅱ级，随机分为2组（n=16）：对照组和AHHD组。AHHD组AHHD完成并稳定10min后、对照组气管插管完成后，静脉注射维库溴铵负荷剂量0．1mg／kg。静脉输注维库溴铵维持L／L5％～15％。于AHHD前、后各时点测定血生化指标，记录维库溴铵起效时间和恢复时间。结果与对照组比较，AHHD组AHHD后Hct、Hb、血浆总蛋白及白蛋白浓度降低，维库溴铵起效时间和恢复时间均缩短（P〈0．05），肝、肾和凝血功能指标差异无统计学意义（P〉0．05）。结论 急性高容量血液稀释可缩短全麻患者维库溴铵的肌松起效时间，加快肌松恢复。

Objective To investigate the effect of acute hypervolemic hemodilution （AHHD） on the onset and recovery of muscle relaxation induced by vecuronium. Methods Thirty-two ASA Ⅰor Ⅱ patients undergoing elective surgery under general anesthesia were randomly divided into 2 groups （n = 16 each） ： control group and AHHD group, A loading dose of vecuronium 0.1 mg/kg was given at 10 min after AHHD following tracheal intubation. The muscular relaxation was maintained at T~/To 5% to 15% by supplement with intravenous vecuronium. Blood samples were taken at various times during AHHD for chemical analysis. The onset and recovery time of muscular relaxation were recorded. Results Compared with control group, Hct, Hb and the concentration of TP and Alb were decreased, and the onset and recovery time of vecuronium were shortened in group AHHD （P 〈 0.05 ）. Conclusion Acute hypervolemic hemodilution can shorten the onset and recovery of muscle relaxation of vecuronium in patients under general anethesia.