七氟醚对顺式阿曲库铵肌松效应的影响

Effects of sevoflurane on cisatracurium-produced neuromuscular block

目的研究七氟醚对顺式阿曲库铵肌松效应的影响。方法 60例腹部手术患者随机均分为三组,气管插管后效应室靶控输注丙泊酚(P组)、1.7%七氟醚(S1组)或2.2%七氟醚(S2组)15 min后注入2ED95的顺式阿曲库铵,待T1恢复至5%左右后接微量泵,手动调节顺式阿曲库铵输注速率,维持T1在3%～5%,记录顺式阿曲库铵的起效时间、T1恢复至5%的时间、每30分钟的输注速率、T1 25%和75%恢复时间及恢复指数。结果与P组比较,S1组和S2组的起效时间明显缩短,T1恢复到5%的时间明显延长,输注30、609、0 min时的速率明显减慢(P<0.01),S1组与S2组T1的25%和75%恢复时间明显延长(P<0.05或P<0.01);与S1组比较,S2组的起效时间明显缩短(P<0.01),输注60 min时的速率明显减慢(P<0.05),与输注30 min时的速率比较,S1组和S2组在输注609、0 min时的速率均减慢(P<0.05)。结论七氟醚能明显延长顺式阿曲库铵的作用时间,有时间依赖及剂量依赖趋势。

Objective To evaluate the effects of sevoflurane on cisatraeurium produced neuromuscular block. Methods Sixty patients undergoing selective surgery under general anesthesia were randomly divided into three groups with 20 cases each. Anesthesia was maintained with propofol infusion（group P）, 1.7% sevoflurane （group S1 ） or 2.2% sevoflurane inhalation （group Se ）, respectively. Cisatracurium 0.1 mg/kg was administered at 15 min after intubation, which was followed by continuous infusion. Neuromuscular block was monitored using train-of-four （TOF） stimulation and adjusted manually to keep T1 in 3% to 5%. The onset time, the time of T1 5% recovery, infusion rates per 30 min, recovery index and the times of T1 recovery from 5% to 25% and 75% were recorded. Results The onset time of cisatracuriurn and infusion rates were significantly shorter and the times of T1 5% recovery and T1 recovery from 5 % to 25% were significantly longer in groups of S1 and S2 than those in group P. There was no significant difference in the recovery index among three groups. Conclusion Sevoflurane can enhance the neuromuscular block effect of cisatracurium in the time- and dose-dependent manner.