低温体外循环对顺式阿曲库胺和罗库溴胺用药量的影响

Effect of hypothermia on requirements of cisatracurium or rocuronium in patients undergoing cardiopulmonary bypass

目的观察低温心肺转流(CPB)对顺式阿曲库胺和罗库溴胺用药量的影响。方法择期心脏瓣膜置换手术32例随机分为顺式阿曲库铵(C组)和罗库溴铵(R组)两组,每组16例。全程肌松监测。全凭静脉麻醉。C组以0.1mg/kg顺式阿曲库铵,R组以0.6mg/kg罗库溴铵静脉推注插管,然后持续泵注,适时调整输注速率,维持T1/T0为15%。常规实施CPB,维持血温32℃,记录并计算两组肌松药平均输注速率。结果C组顺式阿曲库胺CPB中平均输注速率显著低于CPB前[(0.73±0.24)μg.kg-1.min-1vs.(1.11±0.25)μg.kg-1.min-1](P<0.05);R组罗库溴铵CPB前、中的输注速率相仿[(3.99±0.90)μg.kg-1.min-1vs.(4.31±0.71)μg.kg-1.min-1](P>0.05)。结论32℃低温行CPB时,维持相同肌松水平的顺式阿曲库胺需求量明显减少;但罗库溴铵用量未受到低温的明显影响。

Objective To investigate the influence of mild hypothermic cardiopulmonary bypass（CPB）on the requirements of cisatracurium or rocuronium.Methods Sixty-two patients scheduled for selective mitral valve replacement were divided into two groups with 16 cases each.Cisatracurium 0.1mg/kg（group C）or rocuronium 0.6mg/kg（group R）was injected for intubation,which was followed by infution to keep T1/T0 at 15% during operation.The mean infusion rates before,during and after CPB were calculated.Results The cisatracurium infusion rate was higher during CPB than that before[（0.73±0.24）μg·kg-1·min-1 vs.（1.11±0.25）μg·kg-1·min-1]（P0.05）.The rocuronium infusion rate during CPB was similar to that before[（3.99±0.90）μg·kg-1·min-1 vs.（4.31±0.71）μg·kg-1· min-1]（P0.05）.Conclusion To keep a same level of neuromuscular blockade,the requirement of cisatracurium is remarkably less during CPB with 32℃ hypothermia than that before CPB,which is not when rocuronium is used instead of cisatracurium.