异氟醚和地氟醚对罗库溴铵肌松作用的影响

Rocuronium Induced Neuromuscular Blockade during Isoflurane and Desflurane Anesthesia

目的 :观察 1 0MAC异氟醚或地氟醚对罗库溴铵增效作用的影响。方法 :选择 18例择期手术病人随机分为地氟醚和异氟醚组 ,每组在静脉诱导麻醉后 ,先测得维持 90 %肌松并达到稳定后罗库溴铵的注射速率 ,然后吸入异氟醚或地氟醚 ,使呼气末浓度为 1 0MAC ,再调整罗库溴铵的注入速率 ,维持 90 %的肌松 ,观察吸入全麻后罗库溴铵的注射速率随时间变化的趋势。结果 :异氟醚、地氟醚均显著降低了罗库溴铵的注入速率 ,且随吸入时间的延长而递减 ,地氟醚与罗库溴铵的协同作用较异氟醚强。结论 :地氟醚、异氟醚均明显增强罗库溴铵的肌松作用 ,而且有显著的时间依赖性 ,地氟醚的作用强于异氟醚。

Objective:To detect the effect of 1 0MAC of isoflurane and desflurane on the neuromuscular blockade introduced by rocuronium. Methods:Eighteen patients undergoing elective surgery were allocated randomly to either isoflurane or desflurane group. At the beginning, a steady infusion rate of rocuronium to maintain 90% of neuromuscular blockade was established in each group. Then the patients were randomly assigned to receiving 1 0MAC end tidal concentration of either isoflurane (group Ⅰ) or desflurane (group Ⅱ). Rocuronium infusion rate was readjusted to maintain 90% neuromuscular blockade. The change of infusion of rocuronium was observed after inhalation of isoflurane or desflurane. Results: Isoflurane and desflurane decreased the infusion dosage of rocuronium significantly. The effect was increased with the prologation of inhalation time. The potentiation effect of desflurane was more pronouced than that of isoflurane. Conclusion:Isoflurane and desflurane can potentiate the muscular relaxation of rocuronium time dependently, and the latter is more potent than the former.