摘要
目的 比较罗库溴铵持续泵注与间断给药的药效学特点 ,探讨其最佳的给药方式。方法 5 0例ASAⅠ～Ⅱ级 ,无神经肌肉疾患 ,全麻下行择期手术的病人 ,随机分成罗库溴铵间断给药组(Ⅰ组 )和持续泵注组 (Ⅱ组 ) ,采用TOF刺激方式 ,监测拇内收肌的收缩反应。记录神经肌肉阻滞的最大阻滞时间及起效时间、恢复过程 ,并记录罗库溴铵的用药量。应用静脉麻醉药诱导及维持。全部病例均未予拮抗 ,使其在安静状态下自然恢复。当TOF恢复至T4/T1≥ 70 %时 ,结束肌松监测 ,呼吸恢复满意后拔管。结果 Ⅰ组维持肌松追加用药的间隔时间平均 (2 9 2 4± 6 2 6 )min ,各次追加的间隔时间之间无明显差异 ;Ⅱ组的平均泵注速率为 (6 31± 1 93) μg·kg-1·min-1,与Ⅰ组单位时间平均用量(5 4 3± 1 4 6 ) μg·kg-1·min-1比较无明显差别。停药后Ⅱ组的肌松恢复过程明显快于Ⅰ组 (P <0 0 1)。Ⅱ组除第一个 30min用量稍大外 ,其余无明显差别。结论 罗库溴铵无蓄积作用。两种给药方式虽单位时间内用药量无明显差别 。
Objective The study was designed to compare the pharmacodynamics of rocuronium administered by continuous infusion and intermittent bolus injection Methods Fifty ASAⅠ Ⅱ patients without any neuromuscular disease undergoing elective surgery under general anesthesia were randomly divided into two groups of 25 patients each In groupⅠ patients received rocuronium by intermittent bolus injection and in group Ⅱ by continuous infusion The responses of adductor pollicis to train of four (TOF) stimulation of ulnar nerve were monitored The onset time, the time of maximal neuromuscular blockade, the spontaneous recovery from paralysis and the total dose of rocuronium were recorded Intravenous anesthesia was used for both induction and maintenance of anesthesia, no patient received reversal of block Neuromuscular blockade monitoring ended when TOF ratio(T 4/T 1)≥70% The patients were extubated when ventilation was satisfactory Results The two groups were comparable with regard to age, sex, weight and duration of operation The mean onset time after rocuronium bolus(0 6mg/kg) was (78 18±15 44) s In group Ⅱ the mean infusion rate was (6 31±1 93)μg·kg -1 ·min -1 which was not significantly different from the amount of rocuronium administered per minute (5 43±1 46)μg·kg -1 ·min -1 in groupⅠ The mean interval between two bolus injection in group Ⅰwas (29 24±6 26) min, and no significant difference was seen between intervals The spontaneous recovery from neuromuscular block was significantly faster in group Ⅱ than that in group Ⅰ Conclusions Rocuronium has no cumulative effect There was no significant difference in the amount of rocuronium administered per unit time between the two groups The spontaneous recovery from neuromuscular block is faster by continuous infusion than that by intermittent bolus injection
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2001年第10期621-623,共3页
Chinese Journal of Anesthesiology
