服用卡马西平对罗库溴铵作用时效的影响

Influences of carbamazepine on the neuromuscular block of rocuronium

目的 观察服用卡马西平对罗库溴铵作用时效的影响.方法 32例择期行开颅手术患者,ASA分级Ⅰ～Ⅱ级,长期服用卡马西平癫痫患者16例（卡马西平组）,未服用卡马西平颅内肿瘤患者16例（非卡马西平组）.采用普鲁泊福、瑞芬太尼靶控输注全凭静脉麻醉,单次静脉注射罗库溴铵0.6 mg/kg后,采用四个成串刺激（TOF）加速度法监测肌松情况,记录两组患者罗库溴铵起效时间,肌松恢复至25%、50%、75%时间及肌松恢复指数.结果 两组罗库溴铵起效时间比较差异无统计学意义（P＞0.05）;卡马西平组肌松恢复至25%、50%、75%时间[分别为（23.9±3.8）、（29.2±4.5）、（36.0±5.4）min]明显短于非卡马西平组[分别为（34.0±2.8）、（40.5±4.6）、（49.9±5.3）min]（P＜0.01）;卡马西平组肌松恢复指数[（12.1±2.9）min]明显短于非卡马西平组[（15.8±3.1）min]（P＜0.05）.结论 服用卡马西平可明显缩短罗库溴铵的临床作用时间和肌松恢复指数,但不影响其起效时间.

Objective To study the influence of carbamazepine on the neuromuscular block induced by rocuronium. Methods Thirty-two ASA Ⅰ- Ⅱ patients scheduled for neurosurgical operations were studied： 16 cases suffered from epilepsy were treated with carbamazepine for 24 to 180 months （carbamazepine group）; the others suffered from intracranial tumors without antiepileptic treatment （noncarbamazepine group）. Anesthesia was induced and maintained with target controlled with propofol 5 μ g/ml was monitored using train-of-four （TOF） stimulation. The onset time and times of muscle relaxation recovery 25%,50%,75% was recorded. Results The onset time was no difference between two groups （P〉0.05）,but the times of muscle relaxation recovery 25%, 50%, 75% in carbamazepine group [（23.9±3.8 ）, （ 29.2 ±4.5 ）, （ 36.0 ± 5.4 ） min] were shorter than those in non-carbamazepine group [（ 34.0 ± 2.8 ）, （40.5 ± 4.6）,（ 49.9 ± 5.3 ） min] （ P 〈 0.01 ）. The recovery index in carbamazepine group [（ 12.1 ± 2.9 ） min] was shorter than that in non-carbamazepine group [（15.8 ± 3.1） min]（P〈0.05 ）. Conclusion The duration of the rocuronium-induced neuromuscular block is significantly shortened by preceding chronic carbamazepine therapy.