中国医药指南
中國醫藥指南
중국의약지남
CHINA MEDICINE GUIDE
2013年
5期
404-405
,共2页
丙泊酚%七氟醚%神经-肌肉阻滞剂%闭环肌松输注%药效
丙泊酚%七氟醚%神經-肌肉阻滯劑%閉環肌鬆輸註%藥效
병박분%칠불미%신경-기육조체제%폐배기송수주%약효
Propofol%Sevoflurane%Neuromuscular-block%Close-loop infuse%Pharmacodynamic
目的：观察七氟醚对闭环肌松输注罗库溴铵药效的影响。方法选择ASAI或II级，年龄40～60岁，择期拟在全麻下行胃癌根治术（手术时间2～3h左右）患者60例，随机分为两组（每组30例）：七氟醚组（S组）和丙泊酚组（P组）。两组患者采用咪唑安定、舒芬太尼、丙泊酚TCI、罗库溴铵麻醉诱导，罗库溴铵用闭环肌松注射系统（CLMRIS-I）采用T1模式进行肌松监测并且闭环输注。气管插管后S组停止丙泊酚输注，吸入3%七氟醚；P组继续丙泊酚TCI。根据脑电双频谱指数（BIS），调整七氟醚的吸入浓度和丙泊酚TCI浓度。记录罗库溴铵的第1、2、3次的增药时间、肌松恢复情况及用药总量等指标。结果两组患者罗库溴铵的第1次增药时间及恢复指数差异无统计学意义（P＞0.05）；与P组相比，S组2、3次增药时间明显延长（P＜0.05）；与P组相比，S组T125%时间、TOFr25%时间延长（P＜0.05）；与P组相比，S组用药总量减少（P＜0.05）。结论七氟醚对罗库溴铵的肌松作用有增效作用，连续吸入2h七氟醚比丙泊酚全凭静脉麻醉罗库溴铵的用量减少38%，但两组患者的肌松恢复指数无差异。
目的：觀察七氟醚對閉環肌鬆輸註囉庫溴銨藥效的影響。方法選擇ASAI或II級，年齡40～60歲，擇期擬在全痳下行胃癌根治術（手術時間2～3h左右）患者60例，隨機分為兩組（每組30例）：七氟醚組（S組）和丙泊酚組（P組）。兩組患者採用咪唑安定、舒芬太尼、丙泊酚TCI、囉庫溴銨痳醉誘導，囉庫溴銨用閉環肌鬆註射繫統（CLMRIS-I）採用T1模式進行肌鬆鑑測併且閉環輸註。氣管插管後S組停止丙泊酚輸註，吸入3%七氟醚；P組繼續丙泊酚TCI。根據腦電雙頻譜指數（BIS），調整七氟醚的吸入濃度和丙泊酚TCI濃度。記錄囉庫溴銨的第1、2、3次的增藥時間、肌鬆恢複情況及用藥總量等指標。結果兩組患者囉庫溴銨的第1次增藥時間及恢複指數差異無統計學意義（P＞0.05）；與P組相比，S組2、3次增藥時間明顯延長（P＜0.05）；與P組相比，S組T125%時間、TOFr25%時間延長（P＜0.05）；與P組相比，S組用藥總量減少（P＜0.05）。結論七氟醚對囉庫溴銨的肌鬆作用有增效作用，連續吸入2h七氟醚比丙泊酚全憑靜脈痳醉囉庫溴銨的用量減少38%，但兩組患者的肌鬆恢複指數無差異。
목적：관찰칠불미대폐배기송수주라고추안약효적영향。방법선택ASAI혹II급，년령40～60세，택기의재전마하행위암근치술（수술시간2～3h좌우）환자60례，수궤분위량조（매조30례）：칠불미조（S조）화병박분조（P조）。량조환자채용미서안정、서분태니、병박분TCI、라고추안마취유도，라고추안용폐배기송주사계통（CLMRIS-I）채용T1모식진행기송감측병차폐배수주。기관삽관후S조정지병박분수주，흡입3%칠불미；P조계속병박분TCI。근거뇌전쌍빈보지수（BIS），조정칠불미적흡입농도화병박분TCI농도。기록라고추안적제1、2、3차적증약시간、기송회복정황급용약총량등지표。결과량조환자라고추안적제1차증약시간급회복지수차이무통계학의의（P＞0.05）；여P조상비，S조2、3차증약시간명현연장（P＜0.05）；여P조상비，S조T125%시간、TOFr25%시간연장（P＜0.05）；여P조상비，S조용약총량감소（P＜0.05）。결론칠불미대라고추안적기송작용유증효작용，련속흡입2h칠불미비병박분전빙정맥마취라고추안적용량감소38%，단량조환자적기송회복지수무차이。
Objective To investigate the effect of Sevoflurane on closed-loop infuse rocuronium pharmacodynamics. Methods sixty ASAⅠorⅡpatients aged 40-60 undergoing elective surgery for stomach cancer lasting for 2 to 3h were allocated two groups of 30 patients each:Sevoflurane(S)group and propofol (P) group.Two groups adopted midazolam, sufentanil, propofol TCI and rocuronium to anesthesia induction. Rocuronium was monitored using T1 mode of closed-loop muscle loose injection(CLMRIS-I) and closed-loop infuse rocuronium. After tracheal intubation,group S stop propofol TCI and inhale 3%sevoflurane;group P continue propofol TCI. According to BIS adjust the depth of inhale sevoflurane or propofol TCI.The following variables were recorded:the interval and dosage of the first,second,third time,the recovery of muscle relaxation and the total amount of rocuronium. Results Two groups of patients rocuronium 1st time drugs and recovery index difference was not statistically significant (P>0.05);compared with the P group, S group 2,3 times increased drμg time was significantly longer (P<0.05).The time of T1 recovering 25%,TOF recovering 25%were longer in group S than those in group P(P<0.05), but the total amount of rocuronium was lesson than those in group P.(P<0.05) Conclusion Sevoflurane inhalation augments the effect of rocuronium, during the 2h the total amount of rocuronium is reduced 38%during sevoflurane anesthesia as compared with propofol anesthesia, There is no significant difference in the recovery index between the two groups.
