摘要
目的探讨丙泊酚-芬太尼麻醉诱导产生低血压时麻黄碱和多巴胺对罗库溴铵起效时间的影响。方法拟行择期全麻手术成年女性患者45例,随机分成麻黄碱组(E组)、多巴胺组(D组)和生理盐水组(C组),每组15例。麻醉诱导时设定丙泊酚血浆靶浓度3μg/ml,待效应室浓度上升到3μg/ml时,静脉注射芬太尼4μg/kg;3min后E组、D组和C组分别静脉注射麻黄碱0.2mg/kg、多巴胺0.05mg/kg或生理盐水2ml;静脉注射芬太尼6min后静脉注射罗库溴铵0.3mg/kg。用BIOZ无创心排监护仪监测血流动力学指标。TOF-GUARD肌松监测仪监测拇内收肌诱发颤搐反应的抑制和恢复过程。结果D组静脉注射多巴胺和E组静脉注射麻黄碱后心输出量和平均动脉压均高于注药前。静脉注射罗库溴铵后的显效时间D组和E组均比C组延长(P<0.01和P<0.05),D组起效时间比E组和C组均长(P<0.05);三组的T1最大抑制程度、临床作用时间、恢复指数、T95和TOF=0.75时间比较均无显著差异(P>0.05)。结论丙泊酚和芬太尼静脉诱导后,静脉注射多巴胺0.05mg/kg或麻黄碱0.2mg/kg可以维持循环稳定,但前者使罗库溴铵0.3mg/kg的起效时间延长,后者无明显影响。
Objective To compare the effect of ephedrine and dopamine on hypotension during induction and the onset time of rocuronium. Methods Forty-five ASA Ⅰ or Ⅱ female patients undergoing elective operation were randomly allocated to three groups （ n = 15 each） ： group ephedrine bolus, group D dopamine bolus and group C saline bolus. Propofol was administrated by target control infusion, while its concentration of effect compartment reached 3 μg/ml, injected a single dose of fentanyl （4 μg/kg）. After patients received bonus of ephedrine 0. 2 mg/kg or dopamine 0. 05 mg/kg or 2 ml of saline respectively, rocuronium 0. 3 mg/kg was administered 6 minutes after fentanyl bolus. Cardiac output （CO）,mean arterial blood pressure （MAP） were recorded by BioZ impedance cardiography. Neuromuscular block was monitored by recording the force of contraction of adductorpolicis muscle with TOF-GUARD. Results CO and MAP were higher after administration of ephedrine or dopamine compared with those before administration. Lag time of rocuronium was 51.0±7.6 s in group E and 55.0±10.9 s group D,which was longer than that of group C（44.0±8.9）s （P 〈 0.01）. Onset time of rocuronium was322±98.3 s in group D,which was prolonged compared with group E（244.0±63.2 s） and group C （231.7±78.4 s） （ P 〈 0.01 ）. Tmax, clinical duration, recovery index, T95 and TOF = 0. 75 were similar in three groups. Conclusion Ephedrine0. 2 mg/kg or dopamine 0. 05 mg/kg can stabilize circulation after propofol-fentanyl induction but dopamine prolongs the onset time of rocuronium（0.3 mg/kg） in female patients.
出处
《河北医药》
CAS
2007年第4期298-300,共3页
Hebei Medical Journal
