国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2009年
5期
407-410
,共4页
新斯的明%拮抗%维库溴铵%残余肌松作用%麻醉
新斯的明%拮抗%維庫溴銨%殘餘肌鬆作用%痳醉
신사적명%길항%유고추안%잔여기송작용%마취
Neostigmine%Antagonism%Vecuronium%Residual neuromuscular blockade%Anesthesia
目的 观察麻醉恢复期新斯的明拮抗小儿和成年全麻患者维库溴铵的残余肌松作用的剂量反应和安全性.方法 全麻下择期手术的小儿和成年患者各50例,维库溴铵首剂0.1 mg/kg,术中必要时追加0.05 mg/kg.采用加速度肌松监测仪监测四个成串反应的比值(train-of-four ratio,TOFR).当TOFR恢复至0.55时,小儿和成年患者分别随机分为5个亚组,分别给予新斯的明10、20、30、50 μg/kg及阿托品5、10、15、25μg/kg,对照组静脉注射生理盐水2 ml.观察TOFR恢复至0.7、0.9、1.0的时间及术后6、24 h恶心呕吐的发生情况.结果 新斯的明明显加快TOFR的恢复(P＜0.05),其中30μg/kg～50μg/kg效果均更明显(P＜0.05).小儿和成年患者新斯的明拮抗维库溴铵残余肌松作用的剂量反应曲线的差异无统计学意义(P＞0.05),拮抗5min时,小儿和成年患者新斯的明的ED95分别为(6.4±10.5)μg/kg和(2.7±19.2)μg/kg.术后6、24 h恶心呕吐情况的差异无统计学意义(P＞0.05).结论 在TOFR恢复至0.55时,小儿和成年患者新斯的明拮抗维库溴铵的残余肌松作用的效果无统计学差异,推荐使用小剂量的新斯的明进行拮抗,剂量不宜超过30μg/kg.
目的 觀察痳醉恢複期新斯的明拮抗小兒和成年全痳患者維庫溴銨的殘餘肌鬆作用的劑量反應和安全性.方法 全痳下擇期手術的小兒和成年患者各50例,維庫溴銨首劑0.1 mg/kg,術中必要時追加0.05 mg/kg.採用加速度肌鬆鑑測儀鑑測四箇成串反應的比值(train-of-four ratio,TOFR).噹TOFR恢複至0.55時,小兒和成年患者分彆隨機分為5箇亞組,分彆給予新斯的明10、20、30、50 μg/kg及阿託品5、10、15、25μg/kg,對照組靜脈註射生理鹽水2 ml.觀察TOFR恢複至0.7、0.9、1.0的時間及術後6、24 h噁心嘔吐的髮生情況.結果 新斯的明明顯加快TOFR的恢複(P＜0.05),其中30μg/kg～50μg/kg效果均更明顯(P＜0.05).小兒和成年患者新斯的明拮抗維庫溴銨殘餘肌鬆作用的劑量反應麯線的差異無統計學意義(P＞0.05),拮抗5min時,小兒和成年患者新斯的明的ED95分彆為(6.4±10.5)μg/kg和(2.7±19.2)μg/kg.術後6、24 h噁心嘔吐情況的差異無統計學意義(P＞0.05).結論 在TOFR恢複至0.55時,小兒和成年患者新斯的明拮抗維庫溴銨的殘餘肌鬆作用的效果無統計學差異,推薦使用小劑量的新斯的明進行拮抗,劑量不宜超過30μg/kg.
목적 관찰마취회복기신사적명길항소인화성년전마환자유고추안적잔여기송작용적제량반응화안전성.방법 전마하택기수술적소인화성년환자각50례,유고추안수제0.1 mg/kg,술중필요시추가0.05 mg/kg.채용가속도기송감측의감측사개성천반응적비치(train-of-four ratio,TOFR).당TOFR회복지0.55시,소인화성년환자분별수궤분위5개아조,분별급여신사적명10、20、30、50 μg/kg급아탁품5、10、15、25μg/kg,대조조정맥주사생리염수2 ml.관찰TOFR회복지0.7、0.9、1.0적시간급술후6、24 h악심구토적발생정황.결과 신사적명명현가쾌TOFR적회복(P＜0.05),기중30μg/kg～50μg/kg효과균경명현(P＜0.05).소인화성년환자신사적명길항유고추안잔여기송작용적제량반응곡선적차이무통계학의의(P＞0.05),길항5min시,소인화성년환자신사적명적ED95분별위(6.4±10.5)μg/kg화(2.7±19.2)μg/kg.술후6、24 h악심구토정황적차이무통계학의의(P＞0.05).결론 재TOFR회복지0.55시,소인화성년환자신사적명길항유고추안적잔여기송작용적효과무통계학차이,추천사용소제량적신사적명진행길항,제량불의초과30μg/kg.
Objective To study the dose-effect relationships and safety for neostigmine as antagonist of vecuronium-inducted residual neuromuscular blockade in children and adults.Methods The first dose of vecuronium was 0.1 mg&g.bolus doses of 0.05 mg/kg vecuronium were injected into 50 children and 50 adult patients as clinically needed during surgery.At an acceleromyography train-of-four ratio(TOFR)recovery of 0.55,neostigmine(10,20,30 or 50 μg/kg)and atropine(5,10,15 or 25 μg/kg)were administrated by random allocation.Group contr01 was administrated saline 2 m1.Time of TOFR recovery of 0.7.0.9 and 1.0 and complication of postoperative nausea and vomiting(PONV)in 6 and 24 hours were also recorded.Results Neostigmine accelerated the recovery of TOFR.It was significant different that the recovery time of four doses of neostigmine compared to group control(P＜0.01),especially the dose of 30 μg/kg～50 μg/kg(P＜0.05).There was no difference in dose-response relationships for neostigmine and the incidence of PONV in 6 hours and 24 hours between pediatric and adult patients(P＞0.05).At the fifth minute after antagonism,ED95 of neostigmine was(6.4±10.5)μg/kg and(2.7±1 9.2)μg/kg respectively in children and adult patients.Conclusion Different doses of neostigrnine ale equally effective against vecuronium in children and adult patients at TOFR recovery of 0.55.Low dose of neostigmine,no more than 30 μg/kg,is suitable for antagonizing residual neuromuscular blockade.
