预注顺阿曲库铵与增大其剂量在全麻诱导中的效果比较

医学研究与教育 ›› 2015, Vol. 32 ›› Issue (2): 20-23.

预注顺阿曲库铵与增大其剂量在全麻诱导中的效果比较

武懿，李永乐，王红杰

河北大学附属医院麻醉科，河北保定 071000

出版日期:2015-04-25 发布日期:2015-04-25
通讯作者: 王红杰（1968—），女，河北保定人，主任医师，博士，硕士生导师，主要从事临床麻醉及麻醉药理学研究。 E-mail: hongjiew68@163.com
作者简介:武懿（1979—），女，河北安新人，主治医师，硕士，主要从事临床麻醉研究。E-mail: 1981939101@qq.com

Comparison of the priming principle of cisatracurium and increasing the dose in duration of anesthesia effect

WU Yi, LI Yongle, WANG Hongjie

Department of Anesthesiology, Affiliated Hospital of Hebei University, Baoding 071000, China

Online:2015-04-25 Published:2015-04-25

摘要/Abstract

摘要： 目的通过观察在全麻诱导插管中，预注顺阿曲库铵和增大其剂量两种给药方式对其起效时间、临床有效时间及肌松效果的影响，并进行对比，指导此药的临床应用。方法选择 18～55 岁，ASA Ⅰ～Ⅱ级择期行妇科手术的女性患者 90 例，随机分为 3 组，每组 30 例，分别为 3ED95 组、预注组（预注顺阿曲库铵 0.015 mg/kg，4 min 后给予 0.135 mg/kg）和4ED95 组。麻醉诱导使用芬太尼、咪达唑仑、丙泊酚，麻醉维持应用靶控微量泵输注丙泊酚、瑞芬太尼，TOF 模式监测肌松情况。记录血压、心率及全身皮肤情况，记录肌松药起效时间、临床有效时间及气管插管条件评级。结果各组麻醉诱导期间血流动力学的变化比较均无统计学意义，各组肌松药起效时间分别是（184±56）s、（141±31）s、（135±45）s，预注组、4ED95 组分别与 3ED95 组之间的比较均有统计学意义（P＜0.05），但 4ED95 与预注组相比较无统计学意义（P＞0.05）；各组临床有效时间分别是（41±8）min、（44±6）min、（53±8）min，4ED95 组分别与3ED95 组、预注组相比较均有统计学意义（P＜0.05），预注组与 3ED95 组比较无统计学意义（P＞0.05）。结论预注顺阿曲库铵与增大其剂量均能加快药物的起效时间，但前者比后者维持的临床有效时间更短，更有利于患者的苏醒及快速拔管。

关键词: 顺阿曲库铵, 预注法, 起效时间, 临床有效时间

Abstract: Objective To study the effects of the priming principle of cisatracurium and increasing the dose on the onset time and the clinical duration. Methods 90 patients ASAⅠ-Ⅱ, aged 18-55 years, scheduled for elective gynecologic surgery were randomly allocated to three groups with 30 cases each. GroupⅠ received cisatracurium 0.15 mg/kg (3ED95). Group Ⅱ received cisatracurium 0.015 mg/kg four minutes before induction and then cisatracurium 0.135 mg/kg. Group Ⅲ received cisatracurium 0.2 mg/kg(4ED95). Neuromuscular block was monitored by a TOF Watch SX accelerograph. The onset time and the clinical duration were recorded.Results The onset times for groupⅠ , Ⅱ and Ⅲ were (184±56) s、 (141±31) s、 (135±45) s seconds respectively. Compared with group I , there was significant difference in group Ⅱ, Ⅲrespectively (P<0.05); the clinical effective time were (41±8) min, (44±6) min, (53±8) min respectively. Compared with that of group Ⅲ, there was a remarkable difference in groupⅠand group Ⅱ(P<0.05). Conclusion The priming principle can significantly shorten cisatracurium onset time of intubation. Compared with increasing the dose, its clinical duration is shorter.

Key words: cisatracurium, priming principle, onset time, clinical duration

中图分类号:

R614.2

武懿，李永乐，王红杰. 预注顺阿曲库铵与增大其剂量在全麻诱导中的效果比较[J]. 医学研究与教育, 2015, 32(2): 20-23.

WU Yi, LI Yongle, WANG Hongjie. Comparison of the priming principle of cisatracurium and increasing the dose in duration of anesthesia effect[J]. Medical Reserch and Education, 2015, 32(2): 20-23.