摘要
目的:研究血液稀释对维库溴铵量-效关系和恢复时相的影响。方法:选择60例ASA Ⅰ级,年龄17～45岁,施择期整形外科手术的患者,其中30例术中采用血液稀释,另30例作为对照。用60%NO_2-O_2-硫喷妥钠-芬太尼维持麻醉。在血液稀释患者,采用静脉取血和快速静脉输注乳酸林格氏液、中分子右旋醣酐和血定安进行血液稀释。血液稀释后Hct从45.7%降至26.2%。用加速度仪监测神经肌肉功能。采用累计给药方法建立维库溴铵的量一效关系曲线。结果:血液稀释能明显左移维库溴铵的量-效关系曲线,与对照组相比,维库溴铵的ED_(50)、ED_(90)和ED_(95)分别降低22%、18%和17%。应用维库溴铵80μg/kg后,其高峰作用时间、临床作用时间、恢复时间和体内作用时间在血液稀释患者明显延长。结论:急性中度血液稀释能明显增强维库溴铵的神经肌肉阻滞效应,延长其作用时间。
Objective: To evaluate the influence of acute moderate hemodilution on the dose-response and timecourse of effect of vecuronium. Method:Sixty patients. ASA grade Ⅰ,aged 17-45 years,scheduled for elective plastic surgery were included in the study,of which,thirty patients underwent hemodilution during surgery and thirty patients did not receive hemodilution as controls. General anesthesia was maintained with 60% nitrous oxide in oxygen,and further increments of thiopental 2 mg/kg or fentanyl 2μg/kg as required. After anesthesia was stable,the status of acute moderate hemodilution was developed by drainage o{ venous blood and intravenous infusion of lactated Ringer'ssolution, 6% dextran and.gelofusine,during which the level of hemoatocrit dropped from 45.7% to 26.2%. Neuromuscular function was assessed by TOF stimulation of accelerometry with the percentage depression of T_1 response used as the study parameter. The dose-response relationships of vecuronium were determined with the cumulative dose-response technique. Result:During hemodilution the dose-response curve of vecuronium was parallelly shifted to the left. Compared to the control patients,ED_(50),ED_(90) and ED_(95) of vecuronium in the hemodilution patients were decreased by 22%,18% and 17%, respectively. Following an intravenous administration of total dose of vecuronium 80μg/kg, vecuronium-induced neuromuscular block was significantly longer in the hemodilution patients than in the control patients. Conclusion:Acute moderate hemodilution could significantly enhance the neuromuscular blocking effect of vecuronium and prolong its duration of action.
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
1998年第3期144-147,共4页
Chinese Journal of Anesthesiology
基金
中国医学科学院中国协和医科大学政策性资助基金
编号954006
卫生部优秀中青年人才专项基金项目
编号97004
