舒芬太尼不同给药方式对顺式阿曲库铵节约效应观察

Sparing effect of sufentail given by different methods of administration on cisatracurium

目的评价舒芬太尼靶控输注和单次给药对顺式阿曲库铵肌肉松弛效应的影响。方法全身麻醉下行择期手术患者64例，随机分为I，Ⅱ组各32例，I组给予舒芬太尼0.4μg／kg＋异丙酚靶控血浆靶浓度3.2mg／L＋顺式阿曲库铵0.15mg／kg顺序静脉注射，术中间断单次静脉注射舒芬太尼；Ⅱ组给予舒芬太尼靶控血浆浓度0.3μg／L＋异丙酚靶控血浆靶浓度3.2mg／L＋顺式阿曲库铵0.15mg／kg静脉顺序注射，术中靶控输注舒芬太尼。记录2组顺式阿曲库铵起效时间、4个成串刺激（train-of—four stimulation，TOF）值恢复至90％时间、术毕患者拔管时间、手术时间、顺式阿曲库铵和舒芬太尼总用量，比较2组人室（T0）、麻醉诱导完成（T1）、气管插管完成（T2）和气管导管拔除（T0）时心率、平均动脉压和血氧饱和度。结果2组顺式阿曲库铵起效时间、手术时间、舒芬太尼总用量比较差异无统计学意义（P〉0.05）；Ⅱ组TOF值恢复至90％时间、拔管时间较I组短（P〈0.05），顺式阿曲库铵总用量较I组少（P〈0.05）。2组T0～T3时间点心率、平均动脉压和血氧饱和度比较差异无统计学意义（P〉0.05）。结论舒芬太尼靶控输注有较明显的顺式阿曲库铵节约效应。

Objective To evaluate the effects of target-controlled infusion and a single-dose administration of sufentail on neuromuscular blocking action of cisatracurium. Methods Sixty-four patients scheduling for selective surgery under general anesthesia were randomly divided into 2 groups, with 32 patients in each group. Group I received sufentanil 0.4 μg/kg, propofol target-controlled infusion （plasma concentration： 3.2 mg/L） and intravenously injection of cisatracurium 0.15 mg/kg in sequence, plus single-dose administration of sufentail during operation. Group II received sufentanil target-controlled infusion （plasma concentration： 0.3 μg/L）, propofol target-controlled infusion （plasma concentration： 3.2 rag/L）, and intravenously injection of cisatracurium 0. 15 mg/kg in sequence, plus target-controlled infusion of sufentail during operation. The onset time of cisatracurium, time of train-of-four stimulation （TOF） restoring to 90%, time of extubation after surgery, time of operation and the total consumption of cisatracurium and sufentail were recorded. The heart rate, mean arterial pressure and blood oxygen saturation were compared at the time points of before anesthesia （T0）, after induction of anesthesia （T1）, after endotracheal intubation （T2） and after tracheal extubation （T3）. Results There were no significant differences in the onset time of cisatracurium, operation duration and the total consumption of sufentanil between two groups （P〉0.05）. Compared with group , the time of TOF restoring to 90% and extubation time were significantly shorter （P〈0.05）, and the consumption of cisatracurium was significantly less （P〈0.05） in group II than that in group I . The heart rate, mean arterial pressure and blood oxygen saturation showed no significant differences between two groups at the time points of T0 to T3 （P〉0.05）. Conclusions Target-controlled infusion of sufentanil has an obvious sparing effect on cisatracurium.