中国临床药理学杂志2017，Vol.33Issue(21)：2120-2123,4.DOI:10.13699/j.cnki.1001-6821.2017.21.009
七氟烷和地氟烷对小儿手术中罗库溴铵持续输注速率的影响
Influences of sevoflurane and desflurane on continuous infusion rate of rocuronium in children undergoing surgery
摘要
Abstract
Objective To observe the influences of 1.3 minimum alveolar concentration (MAC) sevoflurane and desflurane on continuous infusion rate of rocuronium in children undergoing surgery.Methods Sixty children undergoing surgery under general anesthesia were randomly divided into three groups consisting of 20 children each.At first all the patients adopted the target controlled infusion of propofol (plasma concentration 3-4 ag · min-1) for induction and maintenance of anesthesia,and accepted intravenous injection of 0.6 mg · kg-1 rocuronium for intubation.TOF-Watch SX monitor was used to exert a train-of-four stimulation (TOF) at ulnar nerve in wrist,then the adductor pollicis muscle appeared muscle twitch 4 times in turn which was recorded T1,T2,T3and T4 respectively.When T1 at 5％,intravenous infusion of rocuronium began and T1 was maintained at 8％-10％ all the time.The infusion rate of rocuronium was defined the initial state when T1at 8％ -10％ for 5 min (t0).Then the infusion of propofol stopped in desflurane group (treatment Ⅰ group) and sevoflurane group (treatment H group),desflurane and sevoflurane began to be inhaled respectively and maintained end-tidal concentration at 1.3 MAC.Control group continued infusion of propofol.The infusion rates of rocuronium were recorded every 10 min,which marked with t1,t2,t3,t4 respectively(by such analogy).The recovery times of muscle relaxant in three groups were recorded which including the times of T1 from 0 to 25％,T1 from 25％ to 75％ (recovery index),TOF ratio(TOFr) from 0 to 90％.Results In treatment Ⅰ group,treatment Ⅱ group and control group,the initial infusion rates of rocuronium were (9.02 ± 1.94),(9.25 ± 2.01),(9.08 ± 1.96) μg · kg-1 · min-1 respectively.The infusion rates gradually decreased in treatment Ⅰ group and treatment Ⅱ group after sevoflurane and desflurane were inhaled,which were (4.49 ± 0.98),(4.63 ± 1.12) μg · kg-1 · min-1 respectively at t7 (P ＜ 0.05),there were no obvious change in control group at each time point (P ＞ 0.05).Compared with control group,the infusion rates of treatment Ⅰ group and treatment H group decreased significantly at t1-t7 (P ＜ 0.05).Compared with treatment Ⅱ group,the infusion rates of treatment Ⅰ group decreased significantly at t1-t5 (P ＜ 0.05).In treatment Ⅰ group,treatment H group and control group,the time of T1 from 0 to 25％ was (16.65 ± 10.96),(24.30 ± 2.35),(18.25 ± 11.31) min;the time of T1 from 25％ to 75％ (recovery index) were (7.40 ± 2.54),(14.11 ± 3.07),(8.55 ±4.60) min;the time of TOFr from 0 to 90％ were (39.58 ±4.07),(53.05 ±4.12),(40.72 ±5.85) min.Compared with control group,the recovery time of muscle relaxant had no significant different in treatment Ⅱ group (P ＞ 0.05).Compared with treatment Ⅱ group,the recovery time of muscle relaxant had significant difference in treatment Ⅰ group (P ＜ 0.05).There were no serious adverse drug reaction,the incidence of adverse drug reaction no statistical differences in three groups (P ＞ 0.05).Conclusion The 1.3 MAC sevoflurane and desflurane can significantly reduce continuous infusion rate of rocuronium in children,in a certain period of time the effect of desflurane is stronger than sevoflurane,and donot effect muscle relaxant recover time.关键词
小儿/罗库溴铵/七氟烷/地氟烷/神经肌肉阻滞Key words
child/rocuronium/sevoflurane/desflurane/neuromuscular blockade分类
医药卫生引用本文复制引用
康定鑫,姬斌,李军..七氟烷和地氟烷对小儿手术中罗库溴铵持续输注速率的影响[J].中国临床药理学杂志,2017,33(21):2120-2123,4.基金项目
浙江省医药卫生科技基金资助项目(2015KYA157) （2015KYA157）
温州市公益性科技计划基金资助项目(Y20170142) （Y20170142）
