摘要
目的 探讨全麻联合硬外麻醉下不同剂量维库溴铵对腹部肌松阻滞程度和恢复时间的影响 ,为临床实施全麻联合硬外麻醉提供参考。方法 下腹部择期手术的病人 80例 ,随机分为 4组 ,每组 2 0例 :Ⅰ组为全凭静脉麻醉 ,术中以维库溴铵 2 μg·kg-1·min-1维持肌松 ;Ⅱ～Ⅳ组为全麻联合硬外麻醉 :分别以维库溴铵 2 μg·kg-1·min-1、1μg·kg-1·min·-1、0 8μg·kg-1·min-1维持肌松。观察术中、术后眼轮匝肌及腹肌的四个成串刺激TOF值 ,比较神经肌肉阻滞程度及恢复时间及维库溴铵对腹肌肌松作用的影响。结果 Ⅱ、Ⅲ组病人术中腹部的神经肌肉阻滞程度显著优于Ⅰ组和Ⅳ组 (P <0 0 5 ) ;Ⅱ组和Ⅲ组病人腹肌的恢复时间长于Ⅰ组和Ⅳ组 ,差异有显著性 (P <0 0 5 )。结论 全麻联合硬外麻醉可减少维库溴铵的用量 ,使用维库溴铵半量维库溴胺可达到更佳的神经肌肉阻滞程度。
Objective To investigate the different degrees of muscle relaxation and recovery time of different doses of vecuronium during combined general and epidural anesthesia to provide a reference for clinical performing of combined general and epidural anesthe- sia.Methods 80 patiens scheduled for abdominal operation were randomized into 4 groups.Group I recieving total intravenous anesthesia plus 2μg·kg -1 ·min -1 vecuronium.Group Ⅱ～Ⅳ receiving combined general and epidural anesthesia plus 2μg·kg -1 ·min -1 ,1μg·kg -1 ·min -1 ,0.8μg·kg -1 ·min -1 vecuronium infusion respectively.Train-of-four(TOF) ratios and recovery time of rectus abdomens muscle and orbicularis oculi muscle were measured.Results The effect of neuromuscular block in the group Ⅱ and group Ⅲ each was significantly better than that in group Ⅰ and group Ⅳ(P<0.05).The recovery time of rectus abdomen muscle in Group Ⅱ and Ⅲ were significantly longer than that in group Ⅰ and group Ⅳ(P<0.05).Conclusion Combined general and epidural anesthesia can reduce the dosage demand of the vecuronium;Continuously in fusing half deos of vecuronium used in TIVA can get perfect effect during CGEA.
出处
《广西医学》
CAS
2004年第4期477-479,共3页
Guangxi Medical Journal
