增大顺阿曲库铵剂量与罗库溴铵麻醉诱导效果的比较

Comparison of increase of the dose of cisatracurium and rocuronium on the onset time and the clinical duration

目的通过观察不同剂量顺阿曲库铵的起效时间、临床有效时间的变化，并与罗库溴铵比较，为临床手术患者个体化选择肌松药物及剂量提供理论依据。方法ASAI～Ⅱ级择期妇科手术女性患者120例，随机分为4组，每组30例，分别予顺阿曲库铵0．1mg／kg（A组）、0．15mg／kg（B组）、O．2mg／kg（c组）和罗库溴铵0．9mg／kg（D组），咪达唑仑、芬太尼、异丙酚诱导麻醉，观察心率、血压和全身皮肤情况以及TOF的变化，并进行气管插管条件评级。结果各组肌松药起效时间分别是（226±57）s、（184±56）s、（135±45）s、（80-．I-25）S，C组分别与A、B、D相比较均有统计学意义（P〈0．05）；各组临床有效时间分别是（334±5）min、（41±8）min、（534±8）min、（42±11）min，C组分别与A、B、D相比较差异均有统计学意义（P〈0．05）。c组临床有效时间的离差与D组相比较差异有统计学意义（P〈0．05）。结论增大剂量法明显缩短顺阿曲库铵的插管起效时间，但与罗库溴铵相比，临床作用时间延长，便不适于短小外科手术的麻醉，而罗库溴铵临床作用时间的变异性较大，顺阿曲库铵的可控性优于罗库溴铵。

Objective To study the effects of the increase of the dose of cisatracurium and rocuronium on the onset time and the clinical duration. Methods 120 patients ASA I - II, aged 30-55 years, scheduled for elective gynecologic surgery were randomly divided into four groups（n=30）. Group A received cisatracurium 0.10 mg/kg（2×ED95）. Group B received cisatracurium 0.15 mg/kg （3×ED95）. Group C received cisatracurium 0.2 mg/kg（4×ED95）. Group D received rocuronium 0.9 mg/kg. Neuromuscular block was monitored by a TOF Watch SX accelerograph. The onset time and the clinical duration were recorded. Results The onset times for group A, B, C and D were （226±57）s, （184±56）s, （135±45）s, （80±25）s seconds respectively. Compared with group A, B, D, there was statistically difference between group C and those groups （P≤0.05）. The clinical effective time were （33±5）rain, （41±8）min, （53±8）rain, （42±11）min among group A, B, D, respectively, compared with group A, B, D, there were significant difference between group C and those groups （P≤0.05）.Conclusion Increasing dose could significantly shorten cisatracurium onset time of intubation. But compared with rocuronium, clinical duration is longer. Cisatracurium is not suitable for short surgical operation. The clinical effects of rocuronium time variability controllability, cisatracurium is better than that of rocuronium.