罗库溴胺用于重症肌无力患者胸腺切除术的肌松效应

中国临床药理学与治疗学 ›› 2012, Vol. 17 ›› Issue (11): 1263-1267.

罗库溴胺用于重症肌无力患者胸腺切除术的肌松效应

秦雪梅, 鲁卫华, 金孝岠, 姚卫东, 唐宁

皖南医学院附属弋矶山医院麻醉科,芜湖 241001,安徽

收稿日期:2012-04-28 修回日期:2012-07-03 发布日期:2012-12-04
作者简介:鲁卫华,通信作者,男,硕士,主任医师,副教授,研究方向:围术期脏器功能维护。
基金资助:
安徽省卫生厅医学科研项目(2010C066)

Neuromuscular pharmacodynamics of rocumnium bromide in thymectomy of myasthenia gravis patients

QIN Xue-mei, LU Wei-hua, JIN Xiao-ju, YAO Wei-dong, TANG Ning

Department of Anesthesiology, Yijishan Hospital, Wannan Medical College, Wuhu 241001,Anhui,China

Received:2012-04-28 Revised:2012-07-03 Published:2012-12-04

摘要/Abstract

摘要： 目的: 探讨罗库溴铵在重症肌无力(MG)患者胸腺切除术中的肌松效应。方法: 选择本院择期拟行胸腺切除术Ⅰ~Ⅱa型MG患者23例为试验组,20例正常非MG患者为对照组,均采用气管插管全凭静脉麻醉,给予罗库溴铵 0.6 mg/kg 诱导,术中使用肌松监测仪记录罗库溴铵神经肌肉阻滞效应,及应用多功能监测仪进行心率变异性分析。结果: 所有患者麻醉平稳,手术顺利,未见不良反应发生。两组患者各时点平均动脉压(MAP)、HR、心率变异性(HRV)、低频/高频比(LF/HF)差异无统计学意义。试验组肌松起效时间短于对照组,两组之间差异有统计学意义(P<0.05)。两组肌松T₁ 25%恢复时间、T₁ 50%恢复时间、恢复指数差异均无统计学意义。结论: 对Ⅰ~Ⅱa型MG患者使用 0.6 mg/kg 罗库溴铵进行快速诱导行气管插管,肌松起效时间短,维持时间影响小,且不良反应少,可为气管插管提供良好的肌松条件,安全有效地用于MG患者。

关键词: 雄甾烷醇类, 重症肌无力, 神经肌肉阻滞, 心率变异性

Abstract: AIM: To investigate the neuromuscular pharmacodynamics of rocuronium on thymectomy in myasthenia gravis (MG) patients. METHODS: Twenty-three Ⅰ-Ⅱa MG patients undergoing elective thymectomy (Group M) since January 2006 were studied. Another twenty non-MG patients undergoing other elective surgery were included as control group (Group C). All patients were performed under total intravenous anesthesia by tracheal intubation, given a loading dose of rocuronium 0.6 mg/kg as anesthesia induction. Neuromuscular transmission was monitored by measuring the twitch tension of the adductor pollicis muscle. And the heart rate variability (HRV) was analyzed during the surgery. RESULTS: Anesthesia and surgery were carried out successfully without any adverse reaction. The analysis revealed that the MAP, HR, HRV, LF/HF had no significant difference between the two groups at all time points. The onset time was significantly shorter in group M than that in the group C (P<0.05). There were no significant group differences in the recovery time of T₁ to 25%, the recovery time of T₁ to 50%, and the recovery indices (interval, 25%-75%). CONCLUSION: The results show that rocuronium, as anesthesia induction at a dose of 0.6 mg/kg, has a shorter muscle relaxants onset time and a small influence on the maintaining time. It also can result in fewer perioperative complications and provide optimal operating conditions.It is a safe anaesthesia method in thymectomy of Ossermen Ⅰ-Ⅱa MG patients with anesthesia induction by injecting rocuronium.

Key words: Androstanol, Myasthenia gravis, Neuromuscular blockade, Heart rate variability

中图分类号:

R614

秦雪梅, 鲁卫华, 金孝岠, 姚卫东, 唐宁. 罗库溴胺用于重症肌无力患者胸腺切除术的肌松效应[J]. 中国临床药理学与治疗学, 2012, 17(11): 1263-1267.

QIN Xue-mei, LU Wei-hua, JIN Xiao-ju, YAO Wei-dong, TANG Ning. Neuromuscular pharmacodynamics of rocumnium bromide in thymectomy of myasthenia gravis patients[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2012, 17(11): 1263-1267.

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