摘要
５３例择期全麻患者用二种剂量的美维松，观察了心脏病与非心脏病患者的肌松效应、插管条件及其对血流动力学的影响，同时与琥珀胆碱的肌松效应进行比较，以评价美维松的临床使用价值。结果显示：美维松０．１０５ｍｇ·ｋｇ－１、０．１５ｍｇ·ｋｇ－１和琥珀胆碱１ｍｇ·ｋｇ－１的气管插管优良率分别为８７．５％、９６．０％和１００％（Ｐ＞０．０５），起效时间分别为３４３、２８５和６５秒（Ｐ＜０．０５），而无反应期分别为１．３、７．４和５．３分（Ｐ＜０．０５）。静往美维松后心脏病与非心脏病患者的血流动力学参数均无明显变化。结论：美维松的肌松时效与其剂量有关，美维松可以安全地用于非心脏患者和心脏患者的全麻诱导。
To evaluate the hemodynamic effects and pharmacodynamics of a bolus injection of mivacurium (MIV), 27 patients with cardiac disease (CD) and 26 ones with non cardlac disease (NCD) were divided randomly into six groups. The subjects without CD in group Ⅰ, Ⅲ and Ⅴ or ones with CD in group Ⅱ. Ⅳ and Ⅵ received intravenous administration of MIV 0. 105 or 0.15mg· kg-1, or succinylcholine (SUC) 1mg·kg-1 during Induction of anesthesia, respectively. Anesthsia was maintained with nitrous oxideoxygen-fentanyl. Train-of-four stimulation was applied to measuring the neuromuscular transmission function. The hemodynamic parameters were recorded continuously throughout the period of observation. The onset time of MIV 0. 15 mg' kg--',which was shorter than that of MIV 0. 105 mg kg-1, was longer than that of SUC 1mg·kg-1 (P<0. 01). In comparison with those of MIV 0.105 mg·kg-1, time to T1 of 25% rccovery and time of T1 recovery from 25% to 75% were prolonged after MIV 0.15mg·kg-1 (P<0. 05). The levels of HR. MAP, CI, SI and SVRI kept stable in patients with NCD or CD, after a bolus of MIV 0. 15 mg· kg-1, during entire procedures, except those of HR and MAP increased transiently following intubation. The rates of good intubation condition following the administrations of MIV 0. 105. 0.15mg·kg-1 and SUC 1.0mg·kg-1 were 87.5%, 96% and 100% respectively, withollt the statistical differences among them (P>0. 05). In conclusion, the time-response relationship of MIV is related to its dosage and a bolus injection of MIV can be used safely in patients with cardiac disease during clinical anesthesia.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
1995年第11期490-493,共4页
Chinese Journal of Anesthesiology
关键词
美椎松
药效学
血液动力学
Mivacurium Pharmacodynamlcs Hemodynamics
