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高渗氯化钠羟乙基淀粉40注射液对顺式阿曲库铵肌松效应的影响
Influence of infusing hypertonic sodium chloride Hydroxylethyl starch 40 on muscule relaxtion of cisatracium

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DOI:
作者:
赵雪莲
Zhao Xue-lian
作者单位:
河北医科大学第四医院
Department of Anesthesia, the Fourth Hospital of Hebei Medical University
关键词:
高渗氯化钠；羟乙基淀粉；顺式阿曲库铵；电解质
hypertonic saline solution, hetastarch, cisatracium, electrolytes
摘要:
目的：观察高渗氯化钠羟乙基淀粉40注射液（HSS40）对非去极化肌松药顺式阿曲库铵肌松效应的影响。方法：将60例患者按输注液体种类和术毕是否应用新斯的明随机分为四组，即应用HSS40不用新斯的明的HR组和用新斯的明的HC组；应用羟乙基淀粉（HES130/0.4）不用新斯的明的WR组和用新斯的明的WC组。麻醉诱导以靶控输注丙泊酚和瑞芬太尼，病人入睡后静脉注射顺式阿曲库铵（0.15mg/kg）气管插管。术中继续全凭静脉麻醉维持BIS 40～60。采用加速度仪进行尺神经刺激肌松监测。记录肌松药的起效时间 ,临床效应时间及恢复指数。结果：各组首次顺式阿曲库铵起效时间无统计学差异（P>0.05）; HR组和HC组S1~S5各时段临床效应时间均明显短于WR组和WC组（P<0.05）。HR组和WR组顺式阿曲库铵恢复指数无统计学差异（P>0.05）;应用新斯的明的HC组的肌松恢复时间明显长于WC组（P<0.05）。结论：本实验表明应用HSS40可影响顺式阿曲库铵的肌松效应即缩短其临床作用时间，但用新斯的明拮抗则需更长时间。
Objective: The muscle relaxtion drugs’pharmacokinetics were changed for environment of patients changing. The aim of our study was investagating the influence of hypertonic sodium chloride hydroxylet hylstarch 40 injection (HSS40) on cisatracium. Methods: Sixty patients were randomly divided into four groups: the HR group (HSS40) the HC group (HSS40, neostigmine),the WR group(HES130/0.4), the WC group (HES130/0.4,neostigmine). Tracheal intubation was induced by intravenous TCI propofol ( 3μg/ml ) , remifentanyl ( 3 ng/ ml), cisatracurium(0.15mg/kg). Anesthesia maintained with TCI propofol (3μg/kg), remifentanyl (3 ng/ kg～6 ng/ kg) also in order to control BIS from 40 ～ 60.The adductor pollicis muscle following supramaximal eletrica stimutation of the ulnar nerve were monitored. The onset time, clinical action time, time to T1 recover from 25% to75% and recovery index were noted. Results: The onset time of cisatracium of the HR group and the WR group were 3.3±0.4min, 4.5±1.7 min respectively ( P>0.05). The zero response period to TOF of S1~S5 in the HR group was significantly shorter than that in the WR group （P＜0.05).In the HR group and WR group, the recovery index of cisatracurium was not significantly different( P>0.05).But in the HC group, the T1recovery time from 25% to 75% of cistracurium antagonism by neostigmine was longer than that in the WC group （P＜0.05). Conclusions: The action time of cisatracium in patients using HSS40 was shorter than patients using HES130/0.4. While the recovery time antagonism by neostigmine in patients using HSS40 were longer.

 

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