七氟醚吸入麻醉对顺式阿曲库铵肌松效应的影响

Effect of sevoflurance on the muscular relaxant action of cisatracurium

目的:探讨七氟醚吸入麻醉对顺式阿曲库铵肌松效应的影响。方法:行口腔及颌面部外科手术的90例患者随机分为丙泊酚组(45例)和七氟醚组(45例),行常规麻醉后,七氟醚组吸入七氟醚(维持浓度1MAC)维持麻醉,比较2组顺式阿曲库铵起效时间,T1(4个成串刺激引起的第1个肌颤搐)恢复至5%,25%,50%,75%的时间,泵注后每30分钟顺式阿曲库铵输注速度,并计算恢复指数。观察麻醉期间不良反应。结果:七氟醚组30,60,90min顺式阿曲库铵输注速度较0min时显著减小,且显著小于丙泊酚组(P<0.05);丙泊酚组输注速度无显著变化(P>0.05)。七氟醚组顺式阿曲库铵起效时间较丙泊酚组显著缩短,T1恢复至5%,25%,50%及75%的时间均显著延长(P<0.05);两组恢复指数差异无显著性(P>0.05),麻醉期间均无不良反应发生。结论:吸入七氟醚可呈时间依赖性地增强顺式阿曲库铵的肌松效应,缩短顺式阿曲库铵的起效时间,用药安全,为临床合理用药提供参考。

OBJECTIVE To investigate the effect of sevoflurance on the muscular relaxant action of cisatracurium. METHODS 90 patients underwent dental and maxillofacial surgery were randomly divided into propofol group （n = 45） and sevoflurance group （n = 45）, after routine anaesthesia, sevoflurance group inhaled 1 MAC sevoflurance for maintenance, the onset time, time T1 recovered to 5%, 25%, 50% and 75%, infusion rate per 30 minutes and spontaneous recovery index between two groups were compared. RESULTS The infusion rates of cisatracurium at 30, 60 and 90 min in sevoflurance group were statis- tically decreased than the initial rate and propofol group （P〈0. 05）, but no change in infusion rate was observed in propofol group （P〉0. 05）. The onset time of cisatracurium in sevofluranee group was significantly shortened than propofol group （P〈 0. 05）, the time T1 recovered to 5%, 25%, 50% and 75% was prolonged （P〈0. 05）, but no difference in spontaneous recovery index was observed between the two groups （P〉0. 05）. No ADR was observed during the surgery. CONCLUSION Inha- ling sevoflurance can time-dependently enhance the muscular relaxant action of cisatracurium, shorten the onset time, thus it can be safely applied in clinic.