摘要
目的观察吸入不同浓度七氟醚联合丙泊酚麻醉对罗库溴铵药效学的影响。方法选择2014年11月—2015年2月在我院行择期腹部手术患者67例,按随机数字表法分为3组:丙泊酚联合呼气末0.5最低肺泡有效浓度(MAC)七氟醚组(Ⅰ组,24例);丙泊酚联合0.75 MAC七氟醚组(Ⅱ组,20例);丙泊酚联合1 MAC七氟醚组(Ⅲ组,23例)。3组患者采用咪达唑仑0.05 mg/kg、舒芬太尼0.3μg/kg、依托咪酯0.3 mg/kg诱导麻醉,闭环肌松输注系统(CLMRIS)输注2倍95%有效剂量(ED95)的罗库溴铵(0.6 mg/kg),并采用T1模式进行肌松监测。记录罗库溴铵平均使用剂量、恢复指数以及丙泊酚和瑞芬太尼的平均使用剂量。结果Ⅰ~Ⅲ组罗库溴铵平均使用剂量依次降低[(9.71±2.38 vs 7.50±0.98 vs 6.90±1.14)μg·kg^(-1)·min^(-1),F=18.562,P<0.05],3组间恢复指数差异无统计学意义[(8.92±2.62 vs 8.95±2.58 vs 10.30±3.65)min,F=1.577,P>0.05],同时Ⅲ组丙泊酚和瑞芬太尼的平均使用剂量较Ⅰ组、Ⅱ组降低(P<0.05)。结论高浓度的七氟醚可增强罗库溴铵的肌松作用,同时可减少丙泊酚和瑞芬太尼使用量。
Objective To investigate the effect of different concentrations of sevoflurane inhalation combined with propofol anesthesia on rocuronium pharmacodynamics. Methods Sixty-seven patients, who underwent elective abdominal operation in Tianjin Medical University General Hospital from Nov. 2014 to Feb. 2015, were randomly allocated to three groups： propofol combined 0.5 minimum alveolar concentration（MAC） end-tidal concentration of sevoflurane（group Ⅰ, 24cases）, propofol combined 0.75 MAC end-tidal concentration of sevoflurane（group Ⅱ, 20 cases） and propofol combined 1MAC end-tidal concentration of sevoflurane（group Ⅲ, 23 cases）. All those patients were given midazolam 0.05 mg/kg, sufentanil 0.3 μg/kg, etomidate 0.3 mg/kg for anesthesia induction. Rocuronium was given through the T1 mode of Closed-loop muscle relaxant infusion system and infused by 2ED95（0.6 mg/kg）. The following variables were recorded： average consumption dosage of rocuronium, recovery index, averaged consumption dosage of propofol and remifentanil. Results The averaged consumption dosage of rocuronium was decreased in the three groups in turn[（9.71±2.38 vs 7.50±0.98 vs 6.90±1.14）μg·kg^（-1）·min^（-1）,F=18.562,P〈〉0.05]. There was no significant difference in recovery index between the three groups [（8.92±2.62 vs 8.95±2.58 vs 10.30±3.65）min,F=1.577, P〉 0.05]. The average consumption dosage of propofol and remifentanil were lower in group Ⅲ than those of group Ⅰand group Ⅱ（P 〈0.05）. Conclusion High concentration of sevoflurane can enhance neuromuscular blockage effect of rocuronium, and decrease the consumption dosage of propofol and remifentanil.
出处
《天津医药》
CAS
2016年第3期341-344,共4页
Tianjin Medical Journal
基金
中华医学会临床医学科研专项资金项目(13081320517)
关键词
七氟醚
二异丙酚
瑞芬太尼
罗库溴铵
药效学
恢复指数
最低肺泡有效浓度
闭环肌松输注系统
Sevoflurane
Propofol
Remifentanil
Rocuronium
pharmacodynamics
recovery index
minimum alveolar concentration
closed-loop muscle relaxant infusion system
