摘要
【目的】观察全凭静脉麻醉下糖尿病患者罗库溴铵肌松效应与术后肌松残余（PORC）的发生率。【方法】择期行腹腔镜下子宫切除手术患者60例，ASAI～Ⅱ，依据是否合并2型糖尿病分为糖尿病组（DM组）和非糖尿病组（ND组），每组30例。全部患者采用全凭静脉麻醉，麻醉诱导时静脉注射罗库溴铵0．6mg／kg行气管插管。术中采用四个成串刺激（TOF）监测肌松效应。记录起效时间：从注药至T。（0．1Hz单刺激肌颤搐高度）最大抑制所用时间；维持时间：TOFr（4个成串刺激中第4个肌颤搐与第1个肌颤搐的比值即T4／T1）从0恢复到25％所用时间；恢复指数：TOFr从25％恢复到75％的时间，以及拔管即刻TOFr〈90％（定义为POPC）的患者TOFr恢复至90％的时问（PORC持续时间）。监测拔管后及TOFr达90％时的动脉血气结果。【结果】罗库溴铵的起效时间、维持时间两组无显著性差异（P〉0．05），术后PORC发生率DM组高于ND组（P〈0．05）。【结论】与非糖尿病患者比较，全凭静脉麻醉时糖尿病患者罗库溴铵的起效时间、维持时间无显著差异，但PORC发生率高且持续时间长。
[Objective] To observe the neuromuscular response to rocuronium for patients with diabetes mellitus under total intravenous anesthesia and postoperative residual nondepolarizing neuromuscular blockade （PORC）. [Methods] According to whether or not the complicated type 2 diabetes mellitus（T2DM）, 60 ASA Ⅰ～ Ⅱ patients scheduled for laparoscopic hysterectomy surgery were divided into diabetes mellitus group（DM group, n = 30） and non-diabetic group（ND group, n = 30）. All patients were given total intravenous anesthe- sia. Anesthesia induction with the intravenous injection of rocuronium 0.6mg/kg was undertaken for tracheal intubation. Train-of-four stimulation（TOF） was used to monitor neuromuscular response during the opera- tion. The onset time[the time from the administration to T1 （0. 1Hz single stimulation twitch height） maxi- mum blockade], the maintenance time[the recovery time of TOFr（ratio of the 4th myopalmus to the 1st myo- palmus, ie. T4/T1 during TOF stimulation） from 0 to 25%] and recovery index[the recovery time of TOFr from 25% to 75% and from less than 90% at immediate extubation（defined as PORC patients） to 90%（PORC duration）] were recorded. The arterial blood gas results after extubation and at TOFr up to 90% were moni- tored. [Results] There was no significant difference in the onset time and maintenance time of rocuronium be- tween two groups（ P 〉0.05）. The incidence of PORC after the operation in DM group was higher than that in ND group（ P 〈0.05）. [Conclusion] There is no significant difference in the onset time and maintenance time of rocuronium under total intravenous anesthesia between diabetic patients and non-diabetic patients. But dia- betic patients have a higher incidence and duration of PORC.
出处
《医学临床研究》
CAS
2012年第11期2163-2165,共3页
Journal of Clinical Research
