摘要
研究小儿低温体外循环对阿曲库铵肌松作用的影响。选择在体外循环下行心脏手术的小儿20例。并据体外循环低温程度分为A、B两组。麻醉诱导后,用JS-1型肌松监测仪监测神经肌肉阻滞程度。首量阿曲库铵0.5mg/kg静注后,行气管插管。每当T_1恢复至基础值25%时,给予静注阿曲库铵0.2mg/kg,观察记录体外循环前、中、后期维持量阿曲库铵起效时间、作用时间及恢复时间(T_(5～25))的变化。结果:低温体外循环时,维持量起效时间A组由2.7±0.8分缩短至2.3±0.7分,B组由2.5±0.5分缩短至1.9±0.4分。作用时间A组由转流前平均31.4±7.4分延长至76.0±20.2分,B组由31.8±8.6分延长至105.2±28.3分。体温恢复至肛温>34C或转流后两组作用时间仍较体外循环前延长。低温转流中及转流后恢复时间两组均较转流前延迟。B组作用时间在低温转流时及转流后,均较A组明显延长。表明:小儿低温体外循环使阿曲库铵的阻滞效能明显增强,且温度越低,增强越明显。
The effects of hypothermic CPB on the neuromuscular blocking potency of atracurium in 20 pediatric patients, undergoing open heart surgery, were studied. They were divided into two groups according to the lowest rectal temperature during CPB,and neuromuscular functions were monitored. The trachea was intubated after I. V. atracuriurn 0.5mg/kg. When T_1 of TOF ascended to 25% of baseline, atracuriurn 0.2mg/kg was supplemented. The onset time,duration (T_(25%)) and the recovery time (T_(5%～25%)) of atracurium were recorded before,during and after CPB. Onset time of the maintenance dose decreased from 2.7±0.8 min before CPB to 2.3±0.7 min during CPB in group A;and from 2.5±0.5 min to 1.9±0.4 min in group B. During CPB,the T_(25%) prolonged from 31.4±7.4 min to 76.0±20.2min in group A;and from 31.8±8.6 min to 105.2±28.3 min in group B. The prolonged T_(25%) persisted during normothermia or after cessation of CPB. The T_(5%～25%) also prolonged during or after CPB in both groups. The T_(25%) of atracurium in group B was more significantly prolonged than that in group A. The results demonstrate that hypotherrnic CPB significantly increased neuromuscular blocking potency of atracurium in children,and the lower the degree of hypothermia,the longer the neuromuscular duration.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
1996年第9期447-451,共5页
Chinese Journal of Anesthesiology
关键词
阿曲库铵
神经肌肉接头
低温
体外循环
小儿
Atracurium
Neuromuscular junction
Child
Hypothermia, induced
Cardiopulmonary bypass
