罗哌卡因硬膜外阻滞对中青年患者顺式阿曲库铵肌松效应的影响

Effect of Ropivacaine Epidural Block on the Neuromuscular Block Effect of Cisatracurium of Young and Middle-aged Patients

目的观察罗哌卡因硬膜外阻滞对中青年患者顺式阿曲库铵肌松效应的影响。方法选取2013年1月—2014年1月间该院收治全麻符合硬膜外阻滞下行中下腹部手术的中青年患者90例,将其分为观察组以及对照组,每组45例,观察组采取全麻复合硬膜外阻滞麻醉,对照组给予全麻处理,观察组患者硬膜外分次给予0.75%罗哌卡因处理,对照组根据相同方案给予等量生理盐水处理,静脉滴注依托咪酯、芬太尼以及阿曲库铵0.15 mg/kg进行麻醉诱导,持续静脉输注丙泊酚、舒芬太尼以及阿曲库铵以维持麻醉,术中将BIS维持于40~50之间,观察两组顺式阿曲库铵的肌松效应变化情况。结果观察组的临床肌松时间明显长于对照组,观察组的总维持量明显少于对照组,组间比较差异有统计学意义(P<0.05)。结论罗哌卡因对于中青年患者顺式阿曲库铵的起效时间及维持剂量的肌松作用时间无明显影响,但是可以延长其临床作用时间,增强肌松效应。

Objective To observe the effect of ropivacaine epidural block on the neuromuscular block effect of cisatraeurium of young and middle-aged patients. Methods 90 cases of young and middle-aged patients meeting the epidural block lower abdominal surgery admitted and treated in our hospital from January 2013 to January 2014 were selected and divided into two groups with 45 cases in each, the observation group adopted the general anesthesia combined with epidural block, while the control group adopted the general anesthesia treatment, and the observation group adopted the epidural treatment of 0.75 percent of ropivacaine by several times, the control group adopted the equal amount of normal saline according to the same plan, intravenous drip of etomidate, fentanyl and atracurium of 0.15 mg/kg for anesthesia induction and continuous intravenous drip of propofol, sufentauil and cisatracurium for maintenance anesthesia, and the BIS in operation kept from 40 to 50, and the changes of neuromuscular block effect of cisatracurium of the two groups were observed. Results The clinical muscule relaxant time in the observation group was obviously longer than that in the control group, and the total maintenance amount in the observation group was obviously less than that in the control group, and the difference between groups had statistical significance（P〈0.05 ）. Conclusion Ropivacaine had no obvious effect on the onset time and maintenance dose of cisatracurium of young and middle-aged patients, but it can prolong the clinical effect time and enhance the museule relaxant effect.