地塞米松对舒更葡糖逆转罗库溴铵深度神经肌肉阻滞的影响

Influence of dexamethasone on reversal of rocuronium deep neuromuscular blocking by sugammadex

目的探讨单次给予地塞米松对舒更葡糖逆转罗库溴铵深度神经肌肉阻滞的影响。方法选择拟在全身麻醉下行腹腔镜结肠手术患者80例,ASA分级Ⅰ~Ⅱ级,未服用类固醇类药物。将患者随机分为2组,每组各40例。麻醉诱导前试验组给予地塞米松0.15 mg·kg^(-1),对照组给予氯化钠注射液。2组麻醉诱导和维持方案相同,术中均持续给予罗库溴铵5~10μg·kg-1·min^(-1)维持深度肌松,维持强直刺激后计数(PTC)为0~2。术后当PTC为1~2时,静脉注射舒更葡糖2 mg·kg^(-1)。记录4个成串刺激比值(TOFR)恢复至0.9的时间、拔管时间和不良反应发生情况等。结果对照组TOFR恢复至0.9的时间、拔管时间和麻醉后恢复室(PACU)停留时间分别为(6.0±0.7)、(7.5±0.5)、(36.8±5.8)min,试验组分别为(6.0±0.6)、(7.7±0.5)、(39.7±6.2)min,组间比较均无显著差异(P>0.05)。2组术前、给药(舒更葡糖)时、给药后5和10 min,患者的平均动脉压和心率水平比较,差异均无显著意义(P>0.05)。2组均未发生明显不良反应。结论地塞米松0.15 mg·kg^(-1)对舒更葡糖逆转深度神经肌肉阻滞无明显影响。

AIM To study the effect of a single dose of dexamethasone on reversal of rocuronium deep neuromuscular blockade(NMB)by sugammadex.METHODS A total of 80 patients undergoing laparoscopic colon surgeries under general anesthesia were selected,with ASA Ⅰ~Ⅱ,and not taking steroid drug medication.The patients were randomly divided into 2 groups with 40 cases in each group.Before anesthesia induction,the trial group was given dexamethasone 0.15 mg·kg^(-1),and the control group was given the same amount of chloride sodium injection.The induction and maintenance programs of anesthesia were the same in both groups.Rocuronium was administered intravenously for 5~10μg·kg-1·min^(-1) to maintain deep muscle relaxation,and the post-tetanic count(PTC)was maintained at O-2.Afer operation,all patients were immediately intravenously injected with sugammadex at a dose of 2 mg·kg^(-1) when PTC was 1-2.The time for train of four-ratios(TOFR)to reach O.9,extubation time and occurrence of adverse reactions were recorded.RESULTS The time of TOFR recovery to 0.9,extubation time and post-anesthesia care unit(PACU)residence time were(6.0±0.7),(7.5±0.5)and(36.8±5.8)min in the control group,and(6.0±0.6),(7.7±0.5)and(39.7±6.2)min in the trial group,respectively,with no significant differences between the two groups(P>0.05).There were no dfferences in mean arterial pressure and heart rate between the two groups before surgery,at the time of sugammadex administration,and 5 and 10 min after administration(P>0.05).No adverse reactions occurred in the both groups.CONCLUSION Dexamethasone 0.15 mg·kg^(-1) has no significant effect on the reversal of deep NMB by sugammadex.