中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2014年
21期
1647-1650
,共4页
辛燕%郭英%姜雨鸽%张宏
辛燕%郭英%薑雨鴿%張宏
신연%곽영%강우합%장굉
米库氯铵%罗库溴铵%神经肌肉阻滞%预注法
米庫氯銨%囉庫溴銨%神經肌肉阻滯%預註法
미고록안%라고추안%신경기육조체%예주법
Mivacurium%Rocurium%Neuromuscular blockade%Pri ming principle
目的:研究预注不同剂量罗库溴铵对米库氯铵药效的影响。方法选择解放军总医院耳鼻喉科2013年3至9月拟行手术患者120例,经医院伦理委员会审核通过,其亲属签署知情同意书并采用随机数字表法随机均分为4组:Ⅰ组为空白对照组,预注3 ml生理盐水,Ⅱ组、Ⅲ组、Ⅳ组分别预注罗库溴铵0.06、0.075、0.1 mg/kg,3 min后给予插管剂量米库氯铵0.15 mg/kg,记录米库氯铵的起效时间和插管时间、T125%和75%恢复时间、肌张力恢复至T4/T1分别为25%、75%和90%时的时间及恢复指数,以及评价插管条件。结果与Ⅰ组起效时间(280±88) s相比,3个实验组(Ⅱ组、Ⅲ组和Ⅳ组)的起效时间分别为(149±45)、(146±60)、(140±38)s,且明显缩短46.81%、47.75%、49.88%(P<0.01),但3个实验组随着预注剂量的增加,米库氯铵的起效时间差异无统计学意义。与Ⅰ组相比,3个实验组的无反应期延长( P<0.01), T1恢复到25%和75%的时间延长(P<0.01或P<0.05),但其恢复指数并不增加(P=0.13)。结论预注小剂量罗库溴铵能明显缩短米库氯铵的起效时间,而对其作用没有明显影响。3个预注剂量间的药物作用没有明显差异。
目的:研究預註不同劑量囉庫溴銨對米庫氯銨藥效的影響。方法選擇解放軍總醫院耳鼻喉科2013年3至9月擬行手術患者120例,經醫院倫理委員會審覈通過,其親屬籤署知情同意書併採用隨機數字錶法隨機均分為4組:Ⅰ組為空白對照組,預註3 ml生理鹽水,Ⅱ組、Ⅲ組、Ⅳ組分彆預註囉庫溴銨0.06、0.075、0.1 mg/kg,3 min後給予插管劑量米庫氯銨0.15 mg/kg,記錄米庫氯銨的起效時間和插管時間、T125%和75%恢複時間、肌張力恢複至T4/T1分彆為25%、75%和90%時的時間及恢複指數,以及評價插管條件。結果與Ⅰ組起效時間(280±88) s相比,3箇實驗組(Ⅱ組、Ⅲ組和Ⅳ組)的起效時間分彆為(149±45)、(146±60)、(140±38)s,且明顯縮短46.81%、47.75%、49.88%(P<0.01),但3箇實驗組隨著預註劑量的增加,米庫氯銨的起效時間差異無統計學意義。與Ⅰ組相比,3箇實驗組的無反應期延長( P<0.01), T1恢複到25%和75%的時間延長(P<0.01或P<0.05),但其恢複指數併不增加(P=0.13)。結論預註小劑量囉庫溴銨能明顯縮短米庫氯銨的起效時間,而對其作用沒有明顯影響。3箇預註劑量間的藥物作用沒有明顯差異。
목적:연구예주불동제량라고추안대미고록안약효적영향。방법선택해방군총의원이비후과2013년3지9월의행수술환자120례,경의원윤리위원회심핵통과,기친속첨서지정동의서병채용수궤수자표법수궤균분위4조:Ⅰ조위공백대조조,예주3 ml생리염수,Ⅱ조、Ⅲ조、Ⅳ조분별예주라고추안0.06、0.075、0.1 mg/kg,3 min후급여삽관제량미고록안0.15 mg/kg,기록미고록안적기효시간화삽관시간、T125%화75%회복시간、기장력회복지T4/T1분별위25%、75%화90%시적시간급회복지수,이급평개삽관조건。결과여Ⅰ조기효시간(280±88) s상비,3개실험조(Ⅱ조、Ⅲ조화Ⅳ조)적기효시간분별위(149±45)、(146±60)、(140±38)s,차명현축단46.81%、47.75%、49.88%(P<0.01),단3개실험조수착예주제량적증가,미고록안적기효시간차이무통계학의의。여Ⅰ조상비,3개실험조적무반응기연장( P<0.01), T1회복도25%화75%적시간연장(P<0.01혹P<0.05),단기회복지수병불증가(P=0.13)。결론예주소제량라고추안능명현축단미고록안적기효시간,이대기작용몰유명현영향。3개예주제량간적약물작용몰유명현차이。
Objective To explore the effects of pri ming rocuronium on neuromuscular blockade produced by mivacurium.Methods Ethical approval was granted by the medical ethics committee of our hospital with a reference number of C-2013-018-01.A total of 120 ASA physical status Ⅰ and Ⅱ patients undergoing selective otorhinolaryngologic surgery under general anesthesia signed the form of informed consent.And they were randomly divided by a random number table into 4 groups.After a standardized imidazole-propofol-fentanyl induction , they received a saline placebo injection ( GroupⅠ) and a pri ming dose of rocuronium 0.06 mg/kg ( GroupⅡ) , rocuronium 0.075 mg/kg ( Group Ⅲ) and rocuronium 0.1 mg/kg ( Group Ⅳ).An intubating dose of mivacurium 0.15 mg/kg was offered 3 minutes later.Anesthesia was maintained with propofol and remifentanyl continuous infusion.Neuromuscular block was monitored with train of four (TOF) stimulation.The onset time, reappearance of T1 (DUR TOFc 1), times of T1 25% and 75% recovery , recovery index and times of TOF 25%, 75% and 90% recovery were recorded.Results The onset time of mivacurium was significantly shorter and the times of T 1 25% and 75% recovery were significantly longer in groups of Ⅱ, Ⅲ and Ⅳ than those in groupⅠ.No significant difference existed in recovery index among 4 groups.The onset time of mivacurium became progressively shorter with the growing pri ming dose of rocurium among three experiment groups.And it was not statistically significant.Conclusions Pri ming rocuronium decreases the onset and intubating times of mivacurium without effect on recovery index.No significant difference exists in drug effect among 3 experiment groups.