摘要
目的观察全麻过程中琥珀胆碱对后续罗库溴铵剂量效应关系的影响。方法 4 8例ASAI～II级择期全麻手术病人 ,年龄 16 ～6 5岁 ,分为对照组和处理组各 2 4例。对照组麻醉诱导后静注罗库溴铵 ,处理组采用琥珀胆碱 1.5mg/kg插管 ,待肌松作用消失 5min后静注罗库溴铵。各组再分为 4个亚组 (n =6 )分别静注罗库溴铵 15 0、2 0 0、2 5 0、30 0 μg/kg ,观察 4个成串刺激 (TOF)的第 1次反应 (Th)的抑制程度。罗库溴铵剂量对数转换 ,Th抑制百分比概率单位转换后进行直线回归分析 ,求得罗库溴铵量效关系曲线。结果对照组罗库溴铵有效剂量ED50 和ED95为 (193± 6 9)、(36 7± 73) μg/kg ,处理组分别为 (15 8± 35 )、(317± 80 ) μg/kg。处理组罗库溴铵量效关系曲线向左移动 ,有效剂量降低约 15 % (P <0 .0 5 )。结论琥珀胆碱肌松作用消失 5min后 ,仍使后续使用的罗库溴铵肌松效力增强约 15 % 。
Objective To investigate the effect of suxamethonium on the dose-response relationship of subsequently administered rocuronium during balanced anesthesia. Methods Forty-eight ASA grade I～II patients, aged 16～65 years, undergoing elective surgery, were randomly assigned to two groups. In control group (n=24) rocuronium was given after induction of anesthesia. In experiment group (n=24) patients were intubated after 1.5 mg/kg of suxamethonium and rocuronium was given after the complete recovery of neuromuscular blockade from suxamethonium. Anesthesia was induced with valium, fentanyl and thiopental and maintained with N 20-fentanyl and supplement propofol as needed. Patients were further divided into 4 subgroups receiving 150, 200, 250, 300 μg/kg of rocuronium respectively in both groups. The ulner nerve was stimulated at the wrist to measure the accelography of thumb adduction. The relationship between probit-transformed depression of first twitch height of train-of-four stimulation and logarithm dose of rocuronium was analyzed using linear regression. Results ED 50 and ED 95 of rocuronium were (193±69) and (367±73) μg/kg respectively in control group, and (158±35) and (317±80) μg/kg respectively in experiment group (P<0.05). Conclusion Suxamethonium shifts left dose-response curve and potentiats about 15% effects of the neuromuscular blockade of subsequently administered rocuronium. Lower dose of rocuronium are required after prior suxamethonium administration.
出处
《上海第二医科大学学报》
CSCD
2004年第11期973-974,980,共3页
Acta Universitatis Medicinalis Secondae Shanghai
