尼卡地平对维库溴铵和阿曲库铵肌松时效的影响

Effect of nicardipine on the time-response relationships of vecuronium and atracurium

目的 探讨尼卡地平对维库溴铵、阿曲库铵肌松时效的影响。方法 40例 ASA ～ 级择期手术的全麻患者 ,随机分为四组 ,每组 10例。四组病人均行健忘镇痛慢诱导气管内插管。吸入5 0 % N2 O-氧混合气 ,静注芬太尼、羟丁酸钠维持麻醉。 组静注维库溴铵 0 .1m g· kg- 1 (2× ED95 ) ; 组静注阿曲库铵 0 .5 mg· kg- 1 (2× ED95 ) ;收缩压超过基础值 30 %时 , 组和 组均给予尼卡地平2 0μg· kg- 1 ,1min后分别静注与 组、 组同等剂量的维库溴铵或阿曲库铵。用 Biometer加速度仪监测肌松情况。结果 组、 组维库溴铵起效时间分别为 (2 .6± 0 .2 ) min和 (2 .0± 0 .2 ) min, 组、 组阿曲库铵起效时间分别为 (3.1± 0 .7) min和 (2 .3± 0 .5 ) min, 组和 组均明显缩短 (P<0 .0 5 ) ; 组临床作用时间较 组延长 (P <0 .0 5 ) ; 组 T190 %恢复时间及恢复指数较 组延长 (P <0 .0 5 ) ; 组无反应期、T15 0 %恢复时间、90 %恢复时间及恢复指数 ,均长于 组 ; 组无反应期、临床作用时间及 T15 0 %恢复时间均长于 组 ,但无统计学意义 )。结论 尼卡地平能缩短维库溴铵、阿曲库铵的起效时间 ,延长维库溴铵。

Objective To investigate the effect of nicardipine on the time-response relationships of vecuronium and atracuriumMethods Forty ASA grade Ⅰ-Ⅱ patients undergoing elective surgical operations were randomly allocated to four groups A single dose of vecuronium was intravenously administered at twice ED 95(01mg·kg -1) in groupⅠand combined with nicardipine 20μg·kg -1 in group Ⅱ Atracurium was given at the dose of twice ED 95 (05mg·kg -1) in groupⅢ and combined with nicardipine in group Ⅳ Anaesthesia was maintained with 50% nitrous oxide in oxygen and fentanyl in all groups Neuromuscular function was monitored with Biometer accelographResults The onset time of vecuronium was shortened from 26 min (groupⅠ) to 20 min (groupⅡ) (P<005) The onset times of atracurium were 31 and 23 min in group Ⅲ and group Ⅳ, respectively (P<005) Clinical durations was 315 min in groupⅠ and 399 min in group Ⅱ (P<005) T1 90% and recovery index in group Ⅲ and group Ⅳ were 549,702 min and 134,190 min respectively (P<005) The maximum blockade period, T1 50% and T1 90% recovery times ,and recovery index were longer in group Ⅱ than those in groupⅠ, as well as in group Ⅳ than those in group Ⅲ Conclusions It is indicated that nicardipine can potentiate the time-response relationships of vecurorium and atracurium