摘要
目的 评价新辅助化疗因素对胃癌根治术患者顺阿曲库铵肌松效应的影响。方法 择期拟行腹腔镜下胃癌根治术患者60例，年龄48～79岁，BMI 20～27 kg/m2，ASA分级Ⅰ或Ⅱ级。按术前是否接受新辅助化疗分为2组（n＝30）：未化疗组（A组）和新辅助化疗组（B组）。麻醉诱导静脉注射0.15 mg/kg（3×ED95）顺式阿曲库铵，当T1恢复至10%，开始静脉输注顺阿曲库铵，起始剂量为1.5 μg·kg－1·min－1，调整输注速率，调整幅度0.2 μg·kg－1·min－1，维持T1 5%～10%。记录肌松起效时间、无反应时间、T1恢复到10%的时间、肌松恢复指数以及TOF比值恢复至90%的时间；顺阿曲库铵静脉输注开始每隔30 min记录肌松药用量，连续记录3次，共计90 min，计算90 min内顺阿曲库铵的平均输注速率。结果 与A组比较，B组起效时间、恢复指数和TOF比值恢复至90%的时间延长，无反应时间、T1恢复至10%的时间缩短，顺阿曲库铵用量和平均输注速率增加（P〈0.05）。结论 新辅助化疗因素可减弱胃癌根治术患者顺阿曲库铵的肌松效应。
Objective To evaluate the effect of neoadjuvant chemotherapy factor on neuromuscular block induced by cisatracurium in the patients undergoing radical gastrectomy.Methods Sixty American Society of Anesthesiologists physical status Ⅰor Ⅱ patients, aged 48-79 yr, with body mass index of 20-27 kg/m2, scheduled for elective laparoscopic radical gastrectomy, were divided into 2 groups（n=30 each）according to whether the patient received neoadjuvant chemotherapy before operation or not： non-chemotherapy group（group A）and neoadjuvent chemotherapy group（group B）. Anesthesia was induced with cisatracurium 0.15 mg/kg（3×ED95）injected intravenously.When T1 recovered to 10% of control height, IV infusion of cisatracurium was started with an initial dose of 1.5 μg·kg-1·min-1, and the infusion rate was adjusted with the amplitude of 0.2 μg·kg-1·min-1 to maintain T1 at 5%-10% of control height.The onset time, nonresponse time, time for T1 to recover to 10%, recovery index and time for train of four ratio to recover to 90% were recorded.The consumption of cisatracurium was continuously recorded every 30 min starting from IV infusion of cisatracurium for 3 times, 90 min in total.The mean infusion rate within 90 min was calculated.Results Compared with group A, the onset time, recovery index and time for train of four ratio to recover to 90% were significantly prolonged, the nonresponse time and time for T1 to recover to 10% were shortened, and the consumption of cisatracurium and mean infusion rate were increased in group B（P〈0.05）.Conclusion Neoadjuvant chemotherapy factor can weaken neuromuscular block induced by cisatracurium in the patients undergoing radical gastrectomy.
出处
《中华麻醉学杂志》
CSCD
北大核心
2017年第5期588-590,共3页
Chinese Journal of Anesthesiology
关键词
阿曲库铵
化学疗法
辅助
胃肿瘤
神经肌肉阻滞
Atracurium
Chemotherapy, adjuvant
Stomach neoplasms
Neuromuscular blockade
