顺式阿曲库铵用于癫痫手术患者的肌松作用

The pharmacodynamics of cisatracurium in the patients undergoing epilepsy surgery

目的观察顺式阿曲库铵用于癫痫患者的肌松残留作用。方法 50例择期行癫痫手术患者随机均分为两组。患者既往无神经肌肉传导功能方面的疾病。麻醉诱导后5 s内经上肢静脉注入4×ED95剂量的顺式阿曲库铵(A组)或维库溴铵(B组)。监测拇内收肌肌颤搐变化,每当肌颤搐恢复至25%时追加1/3诱导剂量的肌松药。观察气管插管条件及末次追加后肌松恢复时间。结果两组均显示良好的气管插管条件。A组末次追加肌松药后的恢复时间明显短于B组。结论 4×ED95的维库溴铵与顺式阿曲库铵均可提供良好的气管插管条件;但反复追加后维库溴铵蓄积作用较顺式阿曲库铵明显。

Objective To observe the residual neuromuscular blockade of cisatricurium in the patients undergoing epilepsy surgery.Methods Fifty patients scheduled for selective epilepsy surgery were equally allocated into two groups and neuromuscular blockade was monitored with train of four（TOF） stimulation.The patients were free of psychiatric,neurologic,neuromuscular,hepatic,renal,pulmonary and cardiovascular diseases and none of them had a history of unusual susceptibility to muscle relaxants or malignant hyperthermia.4×ED95 dose of cisatricurium（group A） or vecuronium（group B） was injected within 5 seconds during anesthesia induction.Intubation conditions were assessed at T1 = 0 after 4×ED95 of cisatracurium or vecuronium injection.Onset time and clinical duration were recorded.One third of induction dose of cisatracurium or vecuronium was given when T1 recovered to 25%,and recovery time and recovery index of the last dose were recored.ResultsTracheal intubation conditions were all satisfactory in two groups.The recovery index and the duration of TOFr recovered to 70% and 90% were longer after the last dose of vecuronium in group B than those of cisatracurium in group A.No adverse effects were recorded in two groups.Conclusion4×ED95 of cisatricurium or vecuronium can provide satisfactory intubation conditions in the patients undergoing epilepsy surgery.Repeated doses of vecuronium,but not cisatracurium,may cause remarkable cumulative effect.