CAJ | 학술논문

目的：探讨顺磺酸阿曲库铵持续与间断给药不同剂量对椎体骨折患者肌松残余作用的影响。方法选取我院近年来收治椎体骨折患者120例,采用随机数字表法分为4组,即A组、B组、C组和D组,每组30例；A组患者给予微量泵持续输注顺磺酸阿曲库铵1．0μg/( kg·min),B组患者给予微量泵持续输注顺磺酸阿曲库铵0．5μg/( kg·min),C组患者给予静脉间断输注顺磺酸阿曲库铵1．0μg/( kg·min),D组患者给予静脉间断输注顺磺酸阿曲库铵0．5μg/( kg·min)；四组顺磺酸阿曲库铵使用总量相同；比较四组患者麻醉效果,TOFr恢复时间(25%、50%、75%及90%),顺磺酸阿曲库铵使用量,拔管时间,初次睁眼时间,肌力恢复至Ⅳ级及以上时间及持续抬头5 s时间。结果四组患者麻醉总有效率比较差异无统计学意义( P >0．05)；A 组患者 TOFr =25%恢复时间、TOFr=50%恢复时间及 TOFr =75%恢复时间均显著长于其他3组,差异有统计学意义( P <0．05)；A组和C组患者TOFr=90%恢复时间比较差异无统计学意义(P>0．05)；B、C组患者TOFr=50%恢复时间、TOFr=75%恢复时间及TOFr=90%恢复时间均显著长于D组,差异有统计学意义( P<0．05)。四组患者顺磺酸阿曲库铵使用量比较差异无统计学意义( P>0．05)；四组患者拔管时间和初次睁眼时间比较差异无统计学意义(P>0．05)；A组患者肌力恢复至Ⅳ级及以上时间和持续抬头5 s时间均显著长于B组、D组,差异有统计学意义(P<0．05)；A组和C组患者肌力恢复至Ⅳ级及以上时间、持续抬头5 s时间比较差异无统计学意义(P>0．05)。结论顺磺酸阿曲库铵持续与间断给药对椎体骨折患者肌松残余作用、麻醉效果均无明显影响,但持续大剂量输注可延长肌松恢复时间。
목적：탐토순광산아곡고안지속여간단급약불동제량대추체골절환자기송잔여작용적영향。방법선취아원근년래수치추체골절환자120례,채용수궤수자표법분위4조,즉A조、B조、C조화D조,매조30례；A조환자급여미량빙지속수주순광산아곡고안1．0μg/( kg·min),B조환자급여미량빙지속수주순광산아곡고안0．5μg/( kg·min),C조환자급여정맥간단수주순광산아곡고안1．0μg/( kg·min),D조환자급여정맥간단수주순광산아곡고안0．5μg/( kg·min)；사조순광산아곡고안사용총량상동；비교사조환자마취효과,TOFr회복시간(25%、50%、75%급90%),순광산아곡고안사용량,발관시간,초차정안시간,기력회복지Ⅳ급급이상시간급지속태두5 s시간。결과사조환자마취총유효솔비교차이무통계학의의( P >0．05)；A 조환자 TOFr =25%회복시간、TOFr=50%회복시간급 TOFr =75%회복시간균현저장우기타3조,차이유통계학의의( P <0．05)；A조화C조환자TOFr=90%회복시간비교차이무통계학의의(P>0．05)；B、C조환자TOFr=50%회복시간、TOFr=75%회복시간급TOFr=90%회복시간균현저장우D조,차이유통계학의의( P<0．05)。사조환자순광산아곡고안사용량비교차이무통계학의의( P>0．05)；사조환자발관시간화초차정안시간비교차이무통계학의의(P>0．05)；A조환자기력회복지Ⅳ급급이상시간화지속태두5 s시간균현저장우B조、D조,차이유통계학의의(P<0．05)；A조화C조환자기력회복지Ⅳ급급이상시간、지속태두5 s시간비교차이무통계학의의(P>0．05)。결론순광산아곡고안지속여간단급약대추체골절환자기송잔여작용、마취효과균무명현영향,단지속대제량수주가연장기송회복시간。
Objective To investigate the effects of continuous and intermittent administration of different do-ses of cisatracurium on residual neuromuscular blockade of patients with vertebral fractures. Methods 120 patients with vertebral fractures were chosen in recent years in our hospital and randomly divided into 4 groups:group A( n=30)received continuous infusion of cisatracurium by micro pump of 1. 0 μg/(kg·min),group B(n=45)was given continuous infusion of cisatracurium by micro pump of 0. 5 μg/(kg·min),group C(n=45)received intermittent infu-sion of cisatracurium of 1. 0 μg/(kg·min),group D(n=45)received intermittent infusion of cisatracurium of 0. 5 μg/(kg·min);and the anesthesia effect,recovery time of TOFr(25%,50%,75%and 90%),cisatracurium dosage,time of extubation,the first eye opening time,time of muscle strength recovered to gradeⅣ and continuing look up 5 s time of 4 groups were compared. Results There was no significant difference in total effect of anesthesia among 4 groups (P>0. 05). The recovery time of TOFr=25%/50%/75%of group A was significantly longer than those of group B, group C and group D(P<0. 05). There was no significant difference in recovery time of TOFr =90%between group A and group C( P>0. 05 ) . The recovery time of TOFr=50%/75%/90%of group B and group C was significantly longer than group D(P<0. 05). There was no significant difference in cisatracurium dosage among the 4 groups(P>0. 05). There was no significant difference in time of extubation and the first eye opening time among the 4 groups (P>0. 05). The time of muscle strength recovered to gradeⅣand continuing look up 5 s of group A and group C was significantly longer than group B and group D ( P <0. 05 ) . There was no significant difference in time of muscle strength recovered to grade Ⅳ and continuing look up 5 s between group A and group C(P>0. 05). Conclusion Ci-satracurium continuous infusion and intermittent bolus injection have no influence on the residual effect of muscle relax-ant,but continuous infusion may prolong the time of muscle relaxant.