格隆溴铵联合新斯的明拮抗残余肌肉松弛作用的临床效果

Clinical efficacy of glycopyrrolate combined with neostigmine in antagonizing residual effects of the muscle relaxants

目的观察全身麻醉(全麻)恢复期格隆溴铵联合新斯的明拮抗残余肌肉松弛(肌松)作用的临床效果。方法择期行神经外科手术患者60例随机分为两组,每组30例。手术结束时,当4个成串刺激恢复至0.1时实施残余肌松拮抗,试验组静脉注射格隆溴铵4μg/kg+新斯的明0.02 mg/kg,对照组给予阿托品0.01 mg/kg+新斯的明0.02 mg/kg。记录给药前(T0)以及给药后5 min(T1)、10 min(T2)、15 min(T3)、20 min(T4)和30 min(T5)时的SBP、DBP和HR。记录拔管时间和意识恢复时间。结果T1~T3时,两组SBP、DBP和HR高于T0时(P<0.05),试验组SBP、DBP和HR低于对照组(P<0.05)。试验组T4时HR高于对照组(P<0.05)。试验组拔管时间和意识恢复时间短于对照组(P<0.05)。结论为拮抗全麻恢复期的残余肌松作用,联合应用格隆溴铵和新斯的明较联合应用阿托品和新斯的明能较好地维持循环稳定。

Objective To observe the clinical efficacy of glycopyrrolate combined with neostigmine in antagonizing the residual effects of the muscle relaxants in the recovery period of general anesthesia.Methods Sixty patients undergoing elective neurosurgery were randomly divided into two groups with 30 cases each.At the end of operation,when TOF recovered to 0.1,the residual effects of the muscle relaxants were antagonized with an intravenous injection of glycopyrrolate 4μg/kg and neostigmine 0.02 mg/kg in group A or with atropine 0.01 mg/kg and neostigmine 0.02 mg/kg in group B.SBP,DBP and HR were recorded before administration(T0),at 5 minutes(T1),10 minutes(T2),15 minutes(T3),20 minutes(T4)and 30 minutes(T5)after administration.The extubation time and recovery time of consciousness were recorded.Results At T1-T3,SBP,DBP and HR in two groups were significantly higher than those at T0(P<0.05),which were lower in group A than those in group B(P<0.05).HR at T4 was significantly higher in group A than that in group B(P<0.05).The extubation time and consciousness recovery time were shorter in group A than those in group B(P<0.05).Conclusion For antagonizing the residual effects of the muscle relaxants,combined use of glycopyrrolate and neostigmine is better than combined use of atropine and neostigmine in maintaining the circulation stability.