急性高容血液稀释对不同剂量罗库溴铵肌松效应的影响

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。

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

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.