不同浓度七氟烷对顺式阿曲库铵肌松作用的影响

摘要

目的 观察不同浓度七氟烷对顺式阿曲库铵肌松作用的影响.方法 择期全麻下行骨科手术患者60例,随机分为4组(n=15):丙泊酚组(P组)、1%七氟烷组(S1 组)、1.5%七氟烷组(S1.5 组)、2%七氟烷组(S2 组).麻醉诱导后P组静脉输注丙泊酚-瑞芬太尼麻醉维持,S1、S1.5、S2 组分别吸入1%、1.5%和2%浓度的七氟烷维持麻醉.35min后各组均静脉注射顺式阿曲库铵0.15mg/kg.记录静注顺式阿曲库铵至肌颤搐(Th)降至0的时间(T0,即起效时间),Th 恢复至25%、50%、90%的时间(RT25、RT50、RT90)和恢复指数(从RT25至RT75的时间,即RI).结果 与P组相比,S1、S1.5、S2 组RT25、RT50、RT90和RI延长,S2组T0缩短(P<0.05);与S1组相比,S1.5、S2 组RT25、RT50和RT90延长(P<0.05),S2 组RI延长(P< 0.05).结论 吸入1%、1.5%和2%的七氟烷可延长顺式阿曲库铵的作用时间和恢复时间,且呈浓度依赖性;吸入2%的七氟烷还能缩短顺式阿曲库铵起效时间.%Objective To evaluate the effects of sevoflurane on neuromuscular blocking action of cisatracurium.Methods Sixty patients scheduled for orthopaedic surgery under general anesthesia were randomly allocated into 4 groups(?=15):propofol group(P group);l% sevoflurane group (S1 group);l.5% sevoflurane group(S1 5group);2% sevoflurane group(S2 group).After induction,anesthesia was maintained propofol-remifentanil in P group;or 1%,1.5% and 2% sevoflurane in S1,S1.5 and S2 group respectively. Thirty-five minutes later,cisatracurium 0.15mg/kg was injected intravenously in each group.T0,RT25,RT50,RT90 and RI were recorded to evaluate neuromuscular blocking action of cisatracurium.Results Compared with P group,RT25,RT50,RT90 and RI were prolonged in S1,S1.5 and S2 group,meanwhile T0 was shortened in S2 group significantly(P<0.05).Compared with S1 group,RT25,RT50 and RT90 were prolonged in S1.5 and S2 group,meanwhile RI were prolonged in S2 group(P< 0.05).Conclusion Inhaling 1%,1.5% and 2% sevoflurane prolong the action and recovery duration of cisatracurium concentration-dependently.And 2% sevoflurane can shorten the onset time of cisatracurium.