开颅术中过度通气对哌库溴铵时效的影响

Effect of Hyperventilation on the Time Effect of Pipecuronium in Neurosurgery

目的 :研究过度通气对哌库溴铵时效的影响。方法 :选择无神经肌肉疾患 ,ASAⅠ～Ⅱ级择期神经外科手术患者 2 4例 ,随机分成对照组 (A组 ,n =12 )和过度通气组 (B组 ,n =12 ) ,术中控制呼吸 ,维持PaCO2 分别大于或小于 35mmHg。用加速度仪监测拇内收肌收缩反应。观察两组哌库溴铵 0 1mg/kg时效差异。结果 :A、B组起效时间分别为 3 2 1± 0 49分钟和 3 0 8± 0 2 3分钟 ,无显著性差异 ;临床时效分别为 10 4 6 7± 7 33分钟和 87 0 8± 5 45分钟 ,P <0 0 5 ;恢复指数分别为 2 6 2 5± 2 85分钟和 2 3 75± 2 73分钟 ,无显著性差异。结论 :过度通气可使哌库溴铵临床时效缩短 。

Objective:To study the effect of hyperventilation on the time effect of pipecuronium in neurosurgery.Methods:The twenty four patients,ASA grade Ⅰ Ⅱ,undergoing neurosurgery were randomly divided into two groups,control group (A, n= 12)and hyperventilation group (B, n= 12).PaCO 2 was kept>35mmHg or <35mmHg by controlled respiration during surgery.The neuromuscular function was monitored by TOF stimulation mode of accelerometry with the percentage depression of T 1 response serving as the parameter.The time response difference of 0 1mg/kg pipecuronium between the two groups was determined.Results:The effective times of group A and B(from infusion to T 1=0) were 3 21±0 49min and 3 08±0 23min respectively.The clinical effective times (from infusion to T 1=25%)were 104 67±7 33min and 87 08±5 45min respectively ( P< 0 05).The recovery indexes (from T 1=25% to 75%)were 26 25±2 85min and 23 75±2 73min respectively.Conclusion:Hyperventilation with PaCO 2 less than 35mmHg can shorten the clinical effective time of pipecurium without any remarkable changes in the onset time and recovery.