中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2013年
7期
870-872
,共3页
强喆%喻文立%翁亦齐%杜洪印
彊喆%喻文立%翁亦齊%杜洪印
강철%유문립%옹역제%두홍인
输注,静脉内%注射,静脉内%神经肌肉非去极药%肝移植%药理学,临床
輸註,靜脈內%註射,靜脈內%神經肌肉非去極藥%肝移植%藥理學,臨床
수주,정맥내%주사,정맥내%신경기육비거겁약%간이식%약이학,림상
Infusions,intravenous%Injections,intravenous%Neuromuscular nondepolarizing agents%Liver transplantation%Pharmacology,clinical
目的 评价不同给药方式对肝移植术中顺式阿曲库铵临床药效学的影响.方法 择期肝移植术患者24例,年龄18 ～ 63岁,体重60 ～ 88 kg,BMI 20 ～ 30 kg/m2,性别不限,ASA分级Ⅲ级,采用随机数字表法,将其分为2组(n=12):连续静脉输注组(C组)和间断静脉注射组(I组).采用全凭静脉全身麻醉,麻醉诱导后待肌松监测仪显示T1恢复至10％时,C组开始静脉输注顺式阿曲库铵,初始速率1.5 μg· kg-1 ·min-1,调节输注速率,维持T1在10％左右,I组间断静脉注射0.03 mg/kg顺式阿曲库铵,维持T1≤10％,待腹膜关闭后即刻停止使用肌松药.记录顺式阿曲库铵的单位时间用药量、T1由10％恢复至25％的时间、恢复指数和术后自主呼吸恢复的时间.结果 与I组相比,C组顺式阿曲库铵单位时间用药量减少,术后自主呼吸恢复时间缩短(P＜0.05),T1恢复至25％的时间和恢复指数差异均无统计学意义(P＞0.05).结论 与间断静脉注射相比,肝移植术中静脉输注顺式阿曲库铵有助于提高临床肌松效应的效价,有利于减少麻醉恢复期相关并发症的发生.
目的 評價不同給藥方式對肝移植術中順式阿麯庫銨臨床藥效學的影響.方法 擇期肝移植術患者24例,年齡18 ～ 63歲,體重60 ～ 88 kg,BMI 20 ～ 30 kg/m2,性彆不限,ASA分級Ⅲ級,採用隨機數字錶法,將其分為2組(n=12):連續靜脈輸註組(C組)和間斷靜脈註射組(I組).採用全憑靜脈全身痳醉,痳醉誘導後待肌鬆鑑測儀顯示T1恢複至10％時,C組開始靜脈輸註順式阿麯庫銨,初始速率1.5 μg· kg-1 ·min-1,調節輸註速率,維持T1在10％左右,I組間斷靜脈註射0.03 mg/kg順式阿麯庫銨,維持T1≤10％,待腹膜關閉後即刻停止使用肌鬆藥.記錄順式阿麯庫銨的單位時間用藥量、T1由10％恢複至25％的時間、恢複指數和術後自主呼吸恢複的時間.結果 與I組相比,C組順式阿麯庫銨單位時間用藥量減少,術後自主呼吸恢複時間縮短(P＜0.05),T1恢複至25％的時間和恢複指數差異均無統計學意義(P＞0.05).結論 與間斷靜脈註射相比,肝移植術中靜脈輸註順式阿麯庫銨有助于提高臨床肌鬆效應的效價,有利于減少痳醉恢複期相關併髮癥的髮生.
목적 평개불동급약방식대간이식술중순식아곡고안림상약효학적영향.방법 택기간이식술환자24례,년령18 ～ 63세,체중60 ～ 88 kg,BMI 20 ～ 30 kg/m2,성별불한,ASA분급Ⅲ급,채용수궤수자표법,장기분위2조(n=12):련속정맥수주조(C조)화간단정맥주사조(I조).채용전빙정맥전신마취,마취유도후대기송감측의현시T1회복지10％시,C조개시정맥수주순식아곡고안,초시속솔1.5 μg· kg-1 ·min-1,조절수주속솔,유지T1재10％좌우,I조간단정맥주사0.03 mg/kg순식아곡고안,유지T1≤10％,대복막관폐후즉각정지사용기송약.기록순식아곡고안적단위시간용약량、T1유10％회복지25％적시간、회복지수화술후자주호흡회복적시간.결과 여I조상비,C조순식아곡고안단위시간용약량감소,술후자주호흡회복시간축단(P＜0.05),T1회복지25％적시간화회복지수차이균무통계학의의(P＞0.05).결론 여간단정맥주사상비,간이식술중정맥수주순식아곡고안유조우제고림상기송효응적효개,유리우감소마취회복기상관병발증적발생.
Objective To evaluate the effects of different methods of administration on clinical pharmacodynamics of cisatracurium during liver transplantation.Methods Twenty-four ASA physical status Ⅲ patients of both sexes,aged 18-63 yr,weighing 60-88 kg,with body mass index of 20-30 kg/m2,scheduled for elective liver transplantation,were randomly divided into 2 groups (n =12 each):continuous infusion group (group C) and intermittent bolus injection group (group Ⅰ).The total intravenous anesthesia was used during surgery.When T1 recovered to 10％ of control height after induction of anesthesia,continuous infusion of cisatracurium was started with an initial rate of 1.5 μg· kg-1 · min-1,and the infusion rate was manually adjusted to maintain T1 at about 10％ in group C,and intermittent iv boluses of cisatracurium 0.03 mg/kg were given to maintain T1 ≤ 10％ in group Ⅰ.The use of muscle relaxants was stopped immediately after peritoneum closure.The consumption of cisatracurium per minute,time for T1 to recover from 10％ to 25％,recovery index and time for recovery of spontaneous breathing after surgery were recorded.Results Compared with group Ⅰ,the consumption of cisatracurium per minute was significantly reduced and the time for recovery of spontaneous breathing after surgery was shortened (P ＜ 0.05),and no significant changes were found in the time for T1 to recover from 10％ to 25％ and recovery index in group C (P ＞ 0.05).Conclusion Compared with intermittent bolus injection,continuous infusion of cisatracurium during liver transplantation is helpful in improving the clinical potency of the muscle relaxant and in reducing the occurrence of complications during anesthesia recovery period.
