CAJ | 학술논문

目的：比较七氟烷和瑞芬太尼在老年手术麻醉中维库溴铵的协同作用及术后苏醒等方面的差异。方法选择择期行腹腔镜胆囊切除术的气管内插管全身麻醉的患者30例,随机分成两组,每组15例。麻醉诱导均采用咪达唑仑(0.05 mg/kg)、维库溴铵(0.1 mg/kg)、丙泊酚3.5μg/ml联合诱导插管, S组病例吸入七氟烷维持呼气末浓度为1.0MAC, R组病例静脉靶控瑞芬太尼(5 ng/ml)。观察两组患者维库溴铵起效时间(onset time)、临床持续时间(DUR25)、T1/T0(%)恢复到50%的时间(DUR50)、恢复指数(RI)、TOF(T4/T1)=0.7的时间以及停药到睁眼的时间。结果 S组的起效时间、DUR25、DUR50均明显短于R组,而RI、TOF(T4/T1)=0.7的时间及睁眼时间均明显长于R组,差异有统计学意义(P<0.05)。结论在老年患者全身麻醉中,与复合瑞芬太尼相比,复合七氟烷麻醉能使维库溴铵肌松作用增强,消退时间延长。
목적：비교칠불완화서분태니재노년수술마취중유고추안적협동작용급술후소성등방면적차이。방법선택택기행복강경담낭절제술적기관내삽관전신마취적환자30례,수궤분성량조,매조15례。마취유도균채용미체서륜(0.05 mg/kg)、유고추안(0.1 mg/kg)、병박분3.5μg/ml연합유도삽관, S조병례흡입칠불완유지호기말농도위1.0MAC, R조병례정맥파공서분태니(5 ng/ml)。관찰량조환자유고추안기효시간(onset time)、림상지속시간(DUR25)、T1/T0(%)회복도50%적시간(DUR50)、회복지수(RI)、TOF(T4/T1)=0.7적시간이급정약도정안적시간。결과 S조적기효시간、DUR25、DUR50균명현단우R조,이RI、TOF(T4/T1)=0.7적시간급정안시간균명현장우R조,차이유통계학의의(P<0.05)。결론재노년환자전신마취중,여복합서분태니상비,복합칠불완마취능사유고추안기송작용증강,소퇴시간연장。
Objective To compare the effects of sevoflurane and remifentanil on vecuronium-induced neuromuscular block and awakening in the eldly. Methods Thirty patients (ASA II-III) aged 65-80 undergoing laparoscopic cholecystectomy were randomly allocated into two groups, sevoflurane group (group S, n=15) and remifentanil group (group R, n=15). Both groups were induced with midazolam(0.05 mg/kg), vecuronium (0.1 mg/kg) and propofol (3.5μg/ml), maintained with inhalation of 1.0MAC end-tidal concentration of sevoflurane (Group S) or TCI remifentanil 5 ng/ml(group R). The onset time, DUR25,DUR50, recovery index(RI), the time of TOF (T4/T1)=0.7 and eye-opening time were observed. Results The onset time, DUR25, DUR50 of group S were shorter than group R, while RI, the time of TOF(T4/T1)=0.7 and eye-opening time were longer(P<0.05). Conclusion Compared to combined remifentanil, combined sevoflurane would enhance the effect of vecuronium , and prolong the neuromuscular blocking effect.