中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2014年
3期
308-311
,共4页
低温 ,人工%麻醉恢复期%阿曲库铵%神经肌肉阻滞
低溫 ,人工%痳醉恢複期%阿麯庫銨%神經肌肉阻滯
저온 ,인공%마취회복기%아곡고안%신경기육조체
Hypothermia,induced%Anesthesia recovery period%Atracurium%Neuromuscular blockade
目的：评价浅低温对麻醉恢复期患者顺式阿曲库铵肌松恢复的影响。方法择期全麻下行开腹手术患者30例，性别不限，年龄18～64岁，体重指数18～25 kg/m2，ASA分级Ⅰ或Ⅱ级。根据术毕停止输注顺式阿曲库铵时患者体温分为2组：体温36.0～36.9℃为正常体温组（N组，n＝14）和体温34.0～35.9℃为浅低温组（H组，n＝16）。采用TOF-Watch SX?加速度肌松监测仪监测肌松情况，采用四个成串刺激模式，频率为2 Hz ，波宽为0.2 ms ，电流强度为50 mA ，刺激间隔为15 s。术中静脉输注顺式阿曲库铵1～3μg·kg-1·min-1，维持1％＜T1≤10％，手术结束前30 min停止输注。记录恢复指数（T1恢复由25％至75％的时间）、T1恢复由10％至75％的时间和T1恢复由10％至TOF比值为0.9的时间。结果与N组比较，H组恢复指数、T1由10％恢复至75％的时间和T1恢复由10％至TOF比值为0.9的时间延长（ P＜0.05）。结论浅低温可抑制麻醉恢复期患者顺式阿曲库铵的肌松恢复。
目的：評價淺低溫對痳醉恢複期患者順式阿麯庫銨肌鬆恢複的影響。方法擇期全痳下行開腹手術患者30例，性彆不限，年齡18～64歲，體重指數18～25 kg/m2，ASA分級Ⅰ或Ⅱ級。根據術畢停止輸註順式阿麯庫銨時患者體溫分為2組：體溫36.0～36.9℃為正常體溫組（N組，n＝14）和體溫34.0～35.9℃為淺低溫組（H組，n＝16）。採用TOF-Watch SX?加速度肌鬆鑑測儀鑑測肌鬆情況，採用四箇成串刺激模式，頻率為2 Hz ，波寬為0.2 ms ，電流彊度為50 mA ，刺激間隔為15 s。術中靜脈輸註順式阿麯庫銨1～3μg·kg-1·min-1，維持1％＜T1≤10％，手術結束前30 min停止輸註。記錄恢複指數（T1恢複由25％至75％的時間）、T1恢複由10％至75％的時間和T1恢複由10％至TOF比值為0.9的時間。結果與N組比較，H組恢複指數、T1由10％恢複至75％的時間和T1恢複由10％至TOF比值為0.9的時間延長（ P＜0.05）。結論淺低溫可抑製痳醉恢複期患者順式阿麯庫銨的肌鬆恢複。
목적：평개천저온대마취회복기환자순식아곡고안기송회복적영향。방법택기전마하행개복수술환자30례，성별불한，년령18～64세，체중지수18～25 kg/m2，ASA분급Ⅰ혹Ⅱ급。근거술필정지수주순식아곡고안시환자체온분위2조：체온36.0～36.9℃위정상체온조（N조，n＝14）화체온34.0～35.9℃위천저온조（H조，n＝16）。채용TOF-Watch SX?가속도기송감측의감측기송정황，채용사개성천자격모식，빈솔위2 Hz ，파관위0.2 ms ，전류강도위50 mA ，자격간격위15 s。술중정맥수주순식아곡고안1～3μg·kg-1·min-1，유지1％＜T1≤10％，수술결속전30 min정지수주。기록회복지수（T1회복유25％지75％적시간）、T1회복유10％지75％적시간화T1회복유10％지TOF비치위0.9적시간。결과여N조비교，H조회복지수、T1유10％회복지75％적시간화T1회복유10％지TOF비치위0.9적시간연장（ P＜0.05）。결론천저온가억제마취회복기환자순식아곡고안적기송회복。
Objective To evaluate the effect of mild hypothermia on the recovery from cisatracurium blockade during the recovery from anesthesia in patients .Methods Thirty ASA physical status Ⅰ or Ⅱ patients , aged 18-64 yr , with body mass index 18-25 kg/m2 , scheduled for elective abdominal surgery under general anesthesia ,were enrolled in the study .The patients were divided into 2 groups according to the body temperature recorded when cisatracurium infusion was stopped at the end of surgery .The body temperature 36.0-36.9 ℃served as normothermia group (group N , n=14 ) and 34.0-35.9 ℃ served as mild hypothermia group (group H , n= 16 ) . The body temperature was measured by a thermocouple placed in the nasopharynx . Neuromuscular function was monitored by measuring the evoked mechanical response of the adductor pollicis muscle to supramaximal train-of-four (TOF) stimulation (frequency 2 Hz ,wave length 0.2 ms ,intensity 50 mA ,interval 15 s) of the ulnar nerve at the wrist using TOF-Watch SX? .Cisatracurium was intravenously infused at 1-3μg·kg-1 ·min-1 during surgery to maintain neuromuscular block with 1% <first twitch (T1 )≤10% ,and the infusion was stopped at 30 min before the end of surgery .The recovery index (time for T1 to recover from 25% to 75% ) ,time for T1 to recover from 10% to 75% ,and time for T1 to recover from 10% to T4/T1 ratio of 0.9 were recorded . Results Compared with group N ,the recovery index ,time for T1 to recover from 10% to 75% ,and time for T1 to recover from 10% to T4/T1 ratio of 0.9 were significantly prolonged in group H ( P<0.05) .Conclusion Mild hypothermia can inhibit the recovery from cisatracurium blockade during the recovery from anesthesia in patients .
