七氟烷和异氟烷对维库溴铵协同作用及术后苏醒的比较

Comparition of effects of isoflurane and sevoflurane on vecuronium-induced neuromuscular block and awakening

目的:比较七氟烷和异氟烷对维库溴铵的协同作用以及术后苏醒等方面的差异。方法:选择拟施气管内插管的全身麻醉患者40例,随机分为两组,每组20例。麻醉诱导均采用咪唑安定(0.05 mg/kg)加维库溴铵(0.1 mg/kg)加丙泊酚(1.5mg/kg)加舒芬太尼(0.4μg/kg)联合诱导插管,麻醉维持A组患者术中持续吸入1.3 MAC异氟烷,B组患者术中持续吸入1.3MAC七氟烷。结果:两组患者临床肌松时间以及恢复指数比较,差异均无统计学意义(P>0.05);七氟烷组相比较异氟烷组,睁眼及拔管时间均明显缩短,并且苏醒过程平稳,差异有统计学意义(P<0.05)。七氟烷组嗜睡及躁动发生率均少于异氟烷组。结论:七氟烷相比异氟烷有如下优点:苏醒迅速、苏醒期更加平稳舒适、并发症少;二者对维库溴铵的影响在本次实验中未见有显著统计学差异。

Objective To compare the effects of isoflurane and sevoflurane on the vecuronium - induced neuromuscular block and the awakening from general anaesthesia. Method Forty patients undergoing general anesthesia, ASA Ⅱ - Ⅲ, were randomly allocated into two groups, each group had 20 patients. Both groups were induced with midazolam, sufentanil, propofol and vecuronium, maintained only with inhalation of 1.3 MAC end - tidal concentration of either isofiurane （ group A） or sevoflurane （ group B）. Results There is no statistic mean- ing of the chnical musclerelax time and the recovery index between the two groups （ P 〉 0. 05 ）. Awake time, restless after extubation and drowsiness in group B were less than in group A. None from two groups was suffered from awareness. There was a patient from group A and a patient from group B feeled nausea. There was a patient in group A suffered from vomitting while in group B there was none. Conclusion By comparing with isoflurane, sevoflurane has so many advantages ： shorter awakening time, more comfortable awakening course, and less anaesthesia complication.