CAJ | 학술논문

目的观察血清三碘甲状腺原氨酸(T3)、甲状腺素(T4)对七氟醚复合麻醉下罗库溴铵肌肉松驰效应的影响.方法 40例全身麻醉行甲状腺手术女性患者,根据血清T3、T4水平分为甲状腺功能亢进组(N组)与甲状腺功能正常组(C组).麻醉诱导后,静脉注射罗库溴铵0.6 mg/kg,术中以七氟醚复合瑞芬太尼维持麻醉,观察两组的起效时间、T1无反应时间、临床作用时间、恢复指数、体内作用时间、4个成串刺激(TOF)恢复至70％的时间、TOF恢复至90％的时间.结果与C组比较,N组的起效时间[(87±22)s比(108±39)s]、T1无反应时间[(5.8±2.8)min比(22.8±6.1) min]、临床作用时间[(17.3±2.3) min比(34.1±7.4)min]、恢复指数[(8.3±2.1) min比(14.8±4.1) min]、体内作用时间[(32.0±2.6) min比(49.6±7.7) min]、TOF恢复至70％的时间[(36.4±5.6) min比(57.8±7.6) min]和TOF恢复至90％的时间[(42.3±8.4) min比(63.3±8.5) min]均有所缩短(P＜0.05).结论对于血清T3、T4高水平(即甲状腺功能亢进)患者罗库溴铵起效时间缩短,可在较短时间内进行气管插管;甲状腺功能亢进可以缩短七氟醚复合麻醉下罗库溴铵肌肉松驰作用时间,患者术后肌力恢复较快.
목적 관찰혈청삼전갑상선원안산(T3)、갑상선소(T4)대칠불미복합마취하라고추안기육송치효응적영향.방법 40례전신마취행갑상선수술녀성환자,근거혈청T3、T4수평분위갑상선공능항진조(N조)여갑상선공능정상조(C조).마취유도후,정맥주사라고추안0.6 mg/kg,술중이칠불미복합서분태니유지마취,관찰량조적기효시간、T1무반응시간、림상작용시간、회복지수、체내작용시간、4개성천자격(TOF)회복지70％적시간、TOF회복지90％적시간.결과 여C조비교,N조적기효시간[(87±22)s비(108±39)s]、T1무반응시간[(5.8±2.8)min비(22.8±6.1) min]、림상작용시간[(17.3±2.3) min비(34.1±7.4)min]、회복지수[(8.3±2.1) min비(14.8±4.1) min]、체내작용시간[(32.0±2.6) min비(49.6±7.7) min]、TOF회복지70％적시간[(36.4±5.6) min비(57.8±7.6) min]화TOF회복지90％적시간[(42.3±8.4) min비(63.3±8.5) min]균유소축단(P＜0.05).결론 대우혈청T3、T4고수평(즉갑상선공능항진)환자라고추안기효시간축단,가재교단시간내진행기관삽관;갑상선공능항진가이축단칠불미복합마취하라고추안기육송치작용시간,환자술후기력회복교쾌.
Objective To observe the effect of triiodothyronine and thyroxine in blood serum on rocuronium-induced neuromuscular block when combined with sevoflurane anesthesia.Methods Forty female patients,scheduled for thyroid surgery,of American Society of Anesthesiology (ASA) physical status Ⅰ or Ⅱ,were divided into two groups (n =20 each):hyperthyroidism group (group N) and the normal thyroid function group (group C),according to the T3 and T4 levels.After anesthesia was induced,a bolus of rocuronium 0.6 mg/kg was given.Anesthesia was maintained with inhalation of sevoflurane and infusion of remifentanil.Then neuromuscular function was monitored using train-of-four stimulation (TOF) response measured by accelemgraphy.The onset time,no response time,clinical duration,recovery index,response in vivo time,the time of TOF recovery to 70％ and 90％ were recorded.Results As compared with group C,onset time [(87 ± 22) s vs.(108 ± 39) s],T1 no reaction time [(5.8 ±2.8) min vs.(22.8 ± 6.1) min],the clinical duration [(17.3 ± 2.3) min vs.(34.1 ± 7.4) min],recoveryindex [(8.3±2.1) minvs.(14.8±4.1) min],invivotime [(32.0±2.6) minvs.(49.6±7.7) min],the time of TOF recovered to 70％ [(36.4 ±5.6) min vs.(57.8 ±7.6) min] and to 90％[(42.3 ± 8.4) min vs.(63.3 ± 8.5) min] in group N were significantly shortened,P ＜ 0.05 for all.Conclusion For patients with high T3 and T4 levels having a shorter onset time of rocuronium,we can intubate in a relatively short time.Hyperthyroidism can shorten the duration of action of rocuronium when combined with sevoflurane anesthesia,and the strength of muscle can restore faster in these patients.