CAJ | 학술논문

目的：探讨分析右美托咪啶对维库溴铵靶控输注的起效时间和临床作用时间的影响，以便采取合适的临床方案。方法：选取本院2013年3月-2014年6月结肠癌行气管插管全麻患者60例，将其随机分为对照组和研究组，每组30例。对照组患者给予常规维库溴铵靶控输注，研究组在此基础上加用右美托咪啶。对比两组麻醉前（T0）、持续输注Dex后30 min（T1）、60 min（T2）、手术结束时（T3）的心率（HR）、收缩压（SBP）、舒张压（DBP），比较两组患者维库溴铵的起效时间、临床作用时间和靶控浓度，以及拔管后肌松残余和呼吸抑制。结果：研究组T1时段及之后各时段的HR、SBP、DBP显著低于对照组（P<0.01）。研究组起效时间与对照组无显著差异（P>0.05），但临床时效时间和维库溴铵靶控浓度显著降低（P<0.01），研究组肌松残余发生率明显低于对照组（P<0.01），而拔管后呼吸抑制未见差异（P>0.05）。结论：右美托咪啶不会影响维库溴铵的起效时间，但会显著延长临床作用时间，并在一定程度上减少维库溴铵用药量。
목적：탐토분석우미탁미정대유고추안파공수주적기효시간화림상작용시간적영향，이편채취합괄적림상방안。방법：선취본원2013년3월-2014년6월결장암행기관삽관전마환자60례，장기수궤분위대조조화연구조，매조30례。대조조환자급여상규유고추안파공수주，연구조재차기출상가용우미탁미정。대비량조마취전（T0）、지속수주Dex후30 min（T1）、60 min（T2）、수술결속시（T3）적심솔（HR）、수축압（SBP）、서장압（DBP），비교량조환자유고추안적기효시간、림상작용시간화파공농도，이급발관후기송잔여화호흡억제。결과：연구조T1시단급지후각시단적HR、SBP、DBP현저저우대조조（P<0.01）。연구조기효시간여대조조무현저차이（P>0.05），단림상시효시간화유고추안파공농도현저강저（P<0.01），연구조기송잔여발생솔명현저우대조조（P<0.01），이발관후호흡억제미견차이（P>0.05）。결론：우미탁미정불회영향유고추안적기효시간，단회현저연장림상작용시간，병재일정정도상감소유고추안용약량。
Objective:To explore the effect of Dexmedetomidine on onset time and reaction time of Vecuronium target controlled infusion.Method:60 cases of colon cancer patients undergoing general anesthesia were selected in our hospital from March 2013 to June 2014,they were randomly divided into the control group and the study group,each group had 30 cases.Heart rate (HR),systolic blood pressure(SBP),diastolic blood pressure(DBP) were compared between the two groups before anesthesia (T0),after continuous infusion Dex 30 min (T1),60 min(T2),at the end of surgery(T3).Vecuronium onset time,clinical reaction time,target concentration,residual NMB after extubation,and respiratory depression were compared between the two groups.Result:In HR,SBP,DBP,the study group were significantly lower than the control group(P<0.01) at T1 period and after each period.In the onset time,the study group had no significant difference with the control group(P>0.05),but in the clinical aging time and vecuronium target concentration,the study group was lower than the control group (P<0.01),in the incidence of residual NMB,the study group was significantly lower than the control group(P<0.01),but in respiratory depression after extubation,the two groups had no significant difference(P>0.05).Conclusion:Dexmedetomidine does not affect vecuronium onset time but will significantly extend the clinical reaction time and reduce the dosage of vecuronium in a certain extent.