天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (3): 341-344.doi: 10.11958/20150132

• 临床研究 • 上一篇    下一篇

不同浓度七氟醚联合丙泊酚麻醉对罗库溴铵药效学的影响

于凯1,王国林2,闫东来3,4   

  1. 天津医科大学总医院麻醉科， 天津市麻醉学研究所（邮编 300052）
  • 收稿日期:2015-08-27 修回日期:2015-11-22 出版日期:2016-03-15 发布日期:2016-03-15
  • 通讯作者: 闫东来 E-mail:yukai_18@163.com
  • 作者简介:于凯（1984）， 男， 硕士在读， 主要从事临床麻醉研究
  • 基金资助:
    中华医学会临床医学科研专项资金项目

Effects of different concentrations of sevoflurane inhalation combined with propofol anesthesia on rocuronium pharmacodynamics

YU Kai， WANG Guolin， YAN Donglai   

  1. Department of Anesthesiology, Tianjin Medical University General Hospital, Tianjin Research Institute of Anesthesiology,Tianjin 300052, China
  • Received:2015-08-27 Revised:2015-11-22 Published:2016-03-15 Online:2016-03-15
  • Contact: YAN Donglai E-mail:yukai_18@163.com

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摘要： 目的 观察吸入不同浓度七氟醚联合丙泊酚麻醉对罗库溴铵药效学的影响。 方法 选择 2014 年 11 月— 2015 年 2 月在我院行择期腹部手术患者 67 例， 按随机数字表法分为 3 组： 丙泊酚联合呼气末 0.5 最低肺泡有效浓度（MAC）七氟醚组（Ⅰ 组， 24 例）；丙泊酚联合 0.75 MAC 七氟醚组（Ⅱ 组， 20 例）；丙泊酚联合 1 MAC 七氟醚组（Ⅲ组， 23 例）。 3 组患者采用咪达唑仑 0.05 mg/kg、舒芬太尼 0.3 μg/kg、依托咪酯 0.3 mg/kg 诱导麻醉， 闭环肌松输注系统（CLMRIS）输注 2 倍 95%有效剂量（ED95）的罗库溴铵（0.6 mg/kg）， 并采用 T1 模式进行肌松监测。 记录罗库溴铵平均使用剂量、恢复指数以及丙泊酚和瑞芬太尼的平均使用剂量。 结果 Ⅰ ~Ⅲ 组罗库溴铵平均使用剂量依次降低（ [ 9.71±2.38 vs 7.50±0.98 vs 6.90±1.14）μg· kg-1· min-1， F=18.562， P < 0.05]， 3 组间恢复指数差异无统计学意义（ [ 8.92± 2.62 vs 8.95±2.58 vs 10.30±3.65） min， F=1.577， P > 0.05]， 同时Ⅲ组丙泊酚和瑞芬太尼的平均使用剂量较Ⅰ 组、Ⅱ 组降低（P < 0.05）。 结论 高浓度的七氟醚可增强罗库溴铵的肌松作用， 同时可减少丙泊酚和瑞芬太尼使用量。

关键词: 七氟醚, 二异丙酚, 瑞芬太尼, 罗库溴铵, 药效学；恢复指数, 最低肺泡有效浓度, 闭环肌松输注系统

Abstract: Objective To investigate the effect of different concentrations of sevoflurane inhalation combined with pro⁃ pofol anesthesia on rocuronium pharmacodynamics. Methods Sixty-seven patients, who underwent elective abdominal op⁃ eration in Tianjin Medical University General Hospital from Nov. 2014 to Feb. 2015, were randomly allocated to three groups: propofol combined 0.5 minimum alveolar concentration (MAC) end-tidal concentration of sevoflurane (group Ⅰ , 24 cases), propofol combined 0.75 MAC end-tidal concentration of sevoflurane (group Ⅱ , 20 cases) and propofol combined 1 MAC end-tidal concentration of sevoflurane (group Ⅲ, 23 cases). All those patients were given midazolam 0.05 mg/kg, sufen⁃tanil 0.3 μg/kg, etomidate 0.3 mg/kg for anesthesia induction. Rocuronium was given through the T1 mode of Closed-loop muscle relaxant infusion system and infused by 2ED95（0.6 mg/kg). The following variables were recorded: average consump⁃ tion dosage of rocuronium, recovery index, averaged consumption dosage of propofol and remifentanil. Results The aver⁃ aged consumption dosage of rocuronium was decreased in the three groups in turn[（9.71±2.38 vs 7.50±0.98 vs 6.90±1.14） μg· kg-1· min-1， F=18.562， P < 0.05]. There was no significant difference in recovery index between the three groups [（8.92± 2.62 vs 8.95±2.58 vs 10.30±3.65） min， F=1.577, P > 0.05]. The average consumption dosage of propofol and remifentanil were lower in group Ⅲ than those of group Ⅰ and group Ⅱ (P < 0.05). Conclusion High concentration of sevoflurane can enhance neuromuscular blockage effect of rocuronium, and decrease the consumption dosage of propofol and remifentanil

Key words: Sevoflurane, Propofol, Rocuronium, Pharmacodynamics, Closed-loop muscle relaxant infusion system