大剂量法和预注法对顺式阿曲库铵起效时间的影响

Effects of the dose-increasing and the priming principle on the onset time of cisatracurium.

目的观察大剂量法(4倍ED95)和预注法对顺式阿曲库铵起效时间的影响。方法选择ASAⅠ～Ⅱ级全麻妇科择期手术30～55岁患者60例,随机分3组(n=20)。A组(标准组):单次静脉注射顺式阿曲库铵0.15mg/kg(3倍ED95);B组(大剂量组):单次静脉注射顺式阿曲库铵0.20mg/kg(4倍ED95);C组(预注组):诱导前静脉注射顺式阿曲库铵0.03mg/kg,4min后再注射顺式阿曲库铵0.12mg/kg。采用TOF WATCH SX型肌松监测仪进行肌松监测,观察各组肌松药起效时间。结果 A组起效时间(285.1±41.6)s明显长于B组(143.4±28.1)s及C组(189.2±36.2)s,差异有统计学意义(P<0.05)。B组与C组比较,差异无统计学意义(P>0.05)。结论大剂量法与预注法均可明显缩短顺式阿曲库铵起效的时间,但4倍ED95与预注法(总量3倍ED95)两者之间差异无统计学意义。

Objective To study the effects of the dose-increasing and the priming principle on the onset time of cisatracurium.Methods Sixty patients ASAⅠ～Ⅱ,aged 30～55 years,scheduled for elective gynecologic surgery were randomly allocated to three groups with 20 cases each.Group A received cisatracurium 0.15mg/kg（3ED95） only as the control.Group B received cisatracurium 0.20mg/kg（4ED95）.Group C received cisatracurium 0.03mg/kg four minutes before induction and then cisatracurium 0.12mg/kg.Neuromuscular block was monitored by a TOF Watch SX accelerograph.The onset time was recorded.Results The onset times for group A,B and C were（285.1±41.6）,（143.4±28.1）and（189.2±36.2）seconds respectively.The onset time was shorter in groups of B and C than that in group A（P0.05）,which was not significantly different among groups of B and C（P0.05）.Conclusion Both the dose-increasing and the priming principle can decrease the onset time of cisatracurium.There are no significant differences between the effect of the dose-increasing principle and that of the priming principle.