CAJ | 학술논문

[目的]观察全凭静脉麻醉下糖尿病患者罗库溴铵肌松效应与术后肌松残余(PORC)的发生率.[方法]择期行腹腔镜下子宫切除手术患者60例,ASA Ⅰ~Ⅱ,依据是否合并2型糖尿病分为糖尿病组(DM组)和非糖尿病组(ND 组),每组30例.全部患者采用全凭静脉麻醉,麻醉诱导时静脉注射罗库溴铵0.6 mg/kg 行气管插管.术中采用四个成串刺激(TOF)监测肌松效应.记录起效时间:从注药至 T1(0.1 Hz 单刺激肌颤搐高度)最大抑制所用时间;维持时间:TOFr(4个成串刺激中第 4个肌颤搐与第1个肌颤搐的比值即T4/T1)从0恢复到25%所用时间;恢复指数:TOFr 从25%恢复到75%的时间,以及拔管即刻 TOFr <90%(定义为 PORC)的患者 TOFr 恢复至90%的时间(PORC 持续时间).监测拔管后及 TOFr 达90%时的动脉血气结果.[结果]罗库溴铵的起效时间、维持时间两组无显著性差异( P > 0.05),术后 PORC 发生率 DM 组高于 ND 组( P < 0.05).[结论]与非糖尿病患者比较,全凭静脉麻醉时糖尿病患者罗库溴铵的起效时间、维持时间无显著差异,但 PORC 发生率高且持续时间长.
[목적]관찰전빙정맥마취하당뇨병환자라고추안기송효응여술후기송잔여(PORC)적발생솔.[방법]택기행복강경하자궁절제수술환자60례,ASA Ⅰ~Ⅱ,의거시부합병2형당뇨병분위당뇨병조(DM조)화비당뇨병조(ND 조),매조30례.전부환자채용전빙정맥마취,마취유도시정맥주사라고추안0.6 mg/kg 행기관삽관.술중채용사개성천자격(TOF)감측기송효응.기록기효시간:종주약지 T1(0.1 Hz 단자격기전휵고도)최대억제소용시간;유지시간:TOFr(4개성천자격중제 4개기전휵여제1개기전휵적비치즉T4/T1)종0회복도25%소용시간;회복지수:TOFr 종25%회복도75%적시간,이급발관즉각 TOFr <90%(정의위 PORC)적환자 TOFr 회복지90%적시간(PORC 지속시간).감측발관후급 TOFr 체90%시적동맥혈기결과.[결과]라고추안적기효시간、유지시간량조무현저성차이( P > 0.05),술후 PORC 발생솔 DM 조고우 ND 조( P < 0.05).[결론]여비당뇨병환자비교,전빙정맥마취시당뇨병환자라고추안적기효시간、유지시간무현저차이,단 PORC 발생솔고차지속시간장.
Objective] To observe the neuromuscular response to rocuronium for patients with diabetes mellitus under total intravenous anesthesia and postoperative residual nondepolarizing neuromuscular blockade (PORC) .[Methods] According to whether or not the complicated type 2 diabetes mellitus(T2DM ) ,60 ASAⅠ ~ Ⅱ patients scheduled for laparoscopic hysterectomy surgery were divided into diabetes mellitus group (DM group ,n = 30) and non‐diabetic group(ND group ,n = 30) .All patients were given total intravenous anesthe‐sia .Anesthesia induction with the intravenous injection of rocuronium 0 .6mg/kg was undertaken for tracheal intubation .Train‐of‐four stimulation (TOF) was used to monitor neuromuscular response during the opera‐tion .The onset time[the time from the administration to T1 (0 .1Hz single stimulation twitch height ) maxi‐mum blockade] ,the maintenance time[the recovery time of TOFr (ratio of the 4th myopalmus to the 1st myo‐palmus ,ie .T4/T1 during TOF stimulation) from 0 to 25% ] and recovery index [the recovery time of TOFr from 25% to 75% and from less than 90% at immediate extubation(defined as PORC patients) to 90% (PORC duration)] were recorded .The arterial blood gas results after extubation and at TOFr up to 90% were moni‐tored .[Results] There was no significant difference in the onset time and maintenance time of rocuronium be‐tween two groups( P > 0 .05) .The incidence of PORC after the operation in DM group was higher than that in ND group( P < 0 .05) .[Conclusion] There is no significant difference in the onset time and maintenance time of rocuronium under total intravenous anesthesia between diabetic patients and non‐diabetic patients .But dia‐betic patients have a higher incidence and duration of PORC .