顺式阿曲库铵对阻塞性黄疸患者麻醉的药效学研究

Pharmacodynamics of Cisatracurium in Patients of Obstructive Jaundice

目的:观察非去极化肌松药顺式阿曲库铵用于阻塞性黄疸患者麻醉中的肌松效应和安全性。方法:24例阻塞性黄疸患者行胆总管引流术,随机分为顺式阿曲库铵Ⅰ组(2倍ED95组)、Ⅱ组(3倍ED95组),24例切口部位相近行上腹部手术患者随机分为顺式阿曲库铵Ⅲ组(2倍ED95组)、Ⅳ组(3倍ED95组)作为对照。观察诱导前后生命体征的变化、插管条件、肌松效应。结果:各组患者的血流动力学变化:组间比较无显著性差异(P>0.05);Ⅰ、Ⅲ组插管条件为优的比率明显低于Ⅱ、Ⅳ组(P<0.05);Ⅰ组、Ⅲ组起效时间大于Ⅱ组、Ⅳ组,但是T195%恢复时间、四个成串刺激(TOF)比值恢复到70%的时间明显短于Ⅱ组、Ⅳ组(P<0.05)。结论:顺式阿曲库铵可以安全用于阻塞性黄疸患者的麻醉,3ED95剂量的顺式阿曲库铵比2ED95剂量的起效更快,插管条件更好。

Objective： To investigate the pharmacodynamic profiles and security of Cisatracurium in patients of obstructive jaundice. Methods： Twenty-four patients of obstructive jaundice undergoing common bile duct drainage were divided into group Ⅰ （2ED95）, group Ⅱ（3ED95） randomly. As a control group, twenty-four patients undergoing upper abdominal surgery close to the site of incision were divided into group Ⅲ（2ED95）, group Ⅳ（3ED95）. The changes of life parameters both before and after induction, intubation conditions and muscle relaxant effects were observed. Results： There were no significant differences in hemodynamic changes between each group of patients （P〉0.05）. The excellent intubation condition rate in Group Ⅰ, Ⅲ were lower significantly than that of group Ⅱ, Ⅳ（P〈 0.05）. Onset time in group Ⅰ, Ⅲ were longer than that in group Ⅱ, Ⅳ, but their T195 % recovery time and the time of train of four （TOF） ratio back to 70% were significantly shorter than those of group Ⅱ, Ⅳ （P〈0.05）. Conclusions： Cisatracurium can be used safely in patients of obstructive jaundice. 3ED95 of cisatracurium has a faster onset time and better intubation conditions than 2ED95.