急性高容血液稀释对不同剂量罗库溴铵肌松效应的影响

中国临床药理学与治疗学 ›› 2013, Vol. 18 ›› Issue (12): 1396-1400.

急性高容血液稀释对不同剂量罗库溴铵肌松效应的影响

袁晓红¹, 方军¹, 郭建荣², 连燕虹¹, 金孝岠³

¹浙江省肿瘤医院麻醉科,杭州 315000,浙江;
²上海浦东新区公立医院麻醉科,上海 200135;
³皖南医学院附属弋矶山医院麻醉科 ,芜湖 241001,安徽

收稿日期:2013-07-06 修回日期:2013-10-25 出版日期:2013-12-26 发布日期:2014-01-04
通讯作者: 方军,副主任医师,研究方向:麻醉生理与药理学研究。Tel: 0571-88122106 E-mail: fangjunok@126.com
作者简介:袁晓红,女,硕士,住院医师,研究方向:麻醉与器官保护。Tel: 0571-88122106 E-mail: xiaohong123045@yahoo.cn

Acute hypervolemic hemodilution on the role of muscle relaxant effect of different doses Rocuronium

YUAN Xiao-hong¹, FANG Jun¹, GUO Jian-rong², LIAN Yan-hong¹, JIN Xiao-ju³

¹Department of Anesthesiology,Zhejiang Cancer Hospital, Hangzhou 315000, Zhejiang,China;
²Department of Anesthesiology,Gong Li Hospital,Pudong New Area,Shanghai 200135,China;
³Department of Anesthesiology,Yijishan Hospital of Wannan Medical College,Wuhu 241001,Anhui,China

Received:2013-07-06 Revised:2013-10-25 Online:2013-12-26 Published:2014-01-04

摘要/Abstract

摘要： 目的: 观察急性高容血液稀释(AHH)对不同剂量罗库溴铵肌松效应的影响。方法: 择期骨科手术患者80例,ASAⅠ～Ⅱ级,35～60岁。随机分为2组(n=40):A组行急性高容血液稀释(AHH);B组为对照组,常规输血输液。每组患者再随机分为2个亚组(n=20),罗库溴铵剂量分别为 0.6、0.9 mg/kg,咪达唑仑-丙泊酚-瑞芬太尼诱导后,静注相应剂量罗库溴铵后气管插管。观察各组患者的肌松起效时间、肌松维持时间、肌松恢复指数、体内作用时间及肌松残留相关时间。结果: 同一剂量与对照组相比较,起效时间延长,四个成串刺激(TOF)无反应期,肌松阻滞维持时间、体内作用时间明显缩短 (P<0.05),且高剂
量组缩短更为明显(P<0.01);恢复指数和肌松残留相关时间未见明显改变(P>0.05)。结论: 两种剂量的罗库溴铵在肌松监测指导下均能顺利插管,插管评级无统计学差异,其剂量与插管时间成反比;AHH使罗库溴铵药效减弱。

关键词: 急性高容血液稀释, 罗库溴铵, 药效动力学

Abstract: AIM: To compare the muscle relaxant effect of different doses Rocuronium on acute hypervolemic hemodilution.METHODS: Ninety elective 80 cases orthopedic surgery patients, ASA Ⅰ-Ⅱ, 35 to 60 years old, were randomly divided into two groups by the different treatment methods in preoperative transfusion ( n=40 each ): group A acute hypervolemic hemodilution (AHH) and control group ( group B). Each group was divided into two subgroups(n=20 each) with the corresponding loading dose of Rocuronium (0.6, 0.9 mg/kg). Two groups of patients were conducted hemodilution or conventional infusion before induction of anesthesia.The block onset time,the TOF of no response,the block duration,the recovery index of muscle relaxants,and the muscle relaxation time in vivo correlation time left were observed in subgroups.RESULTS: The same dose compared with the control group, the block onset time extension, the TOF of no response, neuromuscular blockade duration, significantly shorter duration of action in vivo (P<0.05), and high-dose group was significantly shorter more (P<0.01). Recovery index and the relevant time of residual neuromuscular did not change significantly (P>0.05).CONCLUSION: Both doses of rocuronium in neuromuscular monitoring can successfully intubated,inversely proportional to dose and duration of intubation. AHH can reduce the pharmacodynamics of rocuronium.

Key words: Acute hypervolemic hemodilution, Rocuronium, Pharmacodynamics

中图分类号:

R614

袁晓红, 方军, 郭建荣, 连燕虹, 金孝岠. 急性高容血液稀释对不同剂量罗库溴铵肌松效应的影响[J]. 中国临床药理学与治疗学, 2013, 18(12): 1396-1400.

YUAN Xiao-hong, FANG Jun, GUO Jian-rong, LIAN Yan-hong, JIN Xiao-ju. Acute hypervolemic hemodilution on the role of muscle relaxant effect of different doses Rocuronium[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2013, 18(12): 1396-1400.

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