急性高容量血液稀释对顺式阿曲库铵起效时间的影响

Effect of acute hypervolemic hemodilution (AHH) on the onset time of cisatracurium (Cis)

目的观察在宫颈癌根治术中应用急性高容量血液稀释对顺式阿曲库铵起效时间的影响。方法选择行宫颈癌根治择期手术60例,年龄35-60岁,ASA分级Ⅰ～Ⅱ级,随机分为两组:AHH组(A组,n=30)和对照组(C组,n=30),两组均在术前补充生理需要量,AHH组以15ml/kg用6%羟乙基淀粉酶130/0.4进行血液稀释,两组分别以用顺式阿曲库铵2倍ED95,3倍ED95,4倍ED95的剂量采用TOF-Watch○R SX肌松监测仪器监测肌松,比较两组的顺式阿曲库铵肌松作用的起效时间,气管插管条件及诱导期的血流动力学变化。结果与C组相比,A组肌松起效时间延长(P<0.05)、CVP增高(P<0.05)、MAP增高但无统计学意义(P>0.05),HR变化无统计学意义。结论 AHH可延长顺式阿曲库铵的起效时间而不会引起血液动力学的显著变化。

Objective To evaluate the effect of acute hypervolemic hemodilution（AHH） on the onset time of cisatracurium （Cis）and hemodynamics in radical hysterectomy of cervical cancer. Methods Sixty patients received radical hysterectomy of cervical cancer , ASA IorⅡ,aged 35y-60y, were randomly divided into two groups（n=30） ： AHH group and C（eontrol） grouP. Both groups supplied physiological requirement before the operation. In group AHH 15 ml/kg 6% hydroxyethyl starch（HES） 130/0.4 solution was infused via internal jugular vein. Each group was divided into 3 subsections by the dosage of Cisatraeuri- urn： 2ED95,3ED95 and4ED95. The response of adductor pollicis muscle to TOF stimulation of ulna nerve was monitored u- sing TOF-Watch SX. The onset time of （Cis） ,the hemodynamic of induction were compared. Results By comparing Group A with Group C,the onset time of eisatraeurium was significantly longer（P〈0.05）,CVP higher（P〈0.05）, MAP higher but with no statistical significance （P〉0.05）, HR （P〉0. 05）. Conclusion AHH can increase the onset time of cisatracurium ef- fectively , without significant hemodynamic changes.