摘要
目的观察静吸复合麻醉下罗库溴铵对小儿与成年人的肌松效应,探讨罗库溴铵用于小儿的作用特点。方法择期全麻手术患者40例,按年龄将患者分为小儿组(2～13岁)和成人组(19～56岁),每组20例。依次静脉注射芬太尼2～3μg/kg,异丙酚1.5～3mg/kg,罗库溴铵0.6mg/kg,应用肌松监测仪四个成串刺激法,连续监测肌松频率、波宽、串间间隔。待T1稳定在100%时,静脉注射罗库溴铵,记录起效时间即罗库溴铵注毕T1下降到0%时行气管插管。恢复时间:罗库溴铵注毕后T1恢复到25%、50%、75%的时间;恢复指数:罗库溴铵注毕后T1从25%到75%的时间。评估插管条件,同时监测呼气末PaCO2及吸入麻醉药物的MAC值。结果小儿组插管条件的优良率(100%)显著高于成人组。小儿组起效时间为(89.6±21.0)s,恢复指数(11.4±5.0)min,成人组起效时间(118.8±24.4)s,恢复指数(13.9±6.1)min。结论2ED95罗库溴铵在小儿组能获得更为满意的插管条件,术中肌松良好,起效和恢复迅速。
Objective To observe the neuromuscular blocking effect of rocuronium in children and adults, and to study the effective characteristics of rocuronium on children. Methods 40 patients, ASA Ⅰ - Ⅱ, scheduled for elective generalanaesthesia-surgery were divided into 2 groups by age. Group A ：20 children,2 - 13 years old;group B： 20 adults,19 -56 years old. Anaesthesia was induced with fentanyl 2 -3 μg/kg and propofol 1.5 -3 mg/kg, and tracheal intubation was facilitated with roeuronium 0. 6 mg/kg. Accelerometry was used to monitor neuromuscular transmission. When the first twitch of the train-of-four（TOF） response（ T1 ）was blocked 100% , the trachea was intubated. The patients were mechanically ventilated and PETCO2 was maintained 30 -40 mmHg. Anesthsia was maintained with isofurane 1 MAC. The onset time and recover time of T1 and TOF ratio（T4/T1 % ）was recorded. Intubating conditions were evaluated according to a standard score. Results Intubating condition of group A was better than that of group B [ （89. 6 ± 21.0）s vs（ 118. 8 ± 24. 4 ）s ], and recovery index of group A was significantly shorter than that in group B [ （ 11.4 ± 5.0） rain vs （ 13.9 ± 6. 1 ） min ]. Conclusion Intubation can be performed under good conditions after a 2 × ED 95 dose of rocuronium in children, and the neuromuscular blocking effect is satisfactory.
出处
《实用药物与临床》
CAS
2009年第5期320-321,共2页
Practical Pharmacy and Clinical Remedies
关键词
罗库溴铵
小儿
成人
肌松药
Rocuronium
Children
Adult
Muscle relaxant
