不同浓度右美托咪定对罗库溴铵肌松作用的影响
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摘要
目的探讨不同浓度右美托咪定对罗库溴铵肌松作用的影响。方法选取200例进行开腹手术的患者,随机分为A、B、C、D四组,每组各50例。各组麻醉诱导均静脉注射舒芬太尼、丙泊酚、罗库溴铵。B、C、D三组于注射舒芬太尼前10 min静脉泵注射右美托咪定,起始剂量分别为0.3、0.6、1.0μg/kg,维持剂量分别为0.3、0.6、1.0μg/(g·h),A组注射等量生理盐水。测定各组患者肌松药物起效时间、临床作用时间、恢复指数,记录并统计麻醉各时间点的平均动脉压、心率。结果四组的罗库溴铵起效时间比较,差异无统计学意义(P>0.05);C、D两组的罗库溴铵临床作用时间均较A组延长,C、D两组的恢复指数均高于A组,差异均有统计学意义(P<0.05)。结论右美托咪定能够增强罗库溴铵的神经肌肉阻滞作用,延长罗库溴铵的临床时效并提高麻醉的恢复指数。
Objective To evaluate the effects of dexmedetomidine of different concentration levels on muscle relaxation by rocuronium. Methods 200 patients to be subjected to laparotomy were randomly divided into four groups, namely, group A(n=50), group B(n=50), group C(n=50), and group D(n=50). All groups were subjected to anesthesia with intravenous injection of sufentanil, propofol and rocuronium. Group B, group C, and group D were injected with dexmedetomidine 10 min before injection of sufentanil. The initial doses were 0.3, 0.6, and 1.0 μg/kg, respectively. The maintenance doses were 0.3, 0.6, and 1.0 μg/(g·h). Group A were injected with the same amount of normal saline. The onset time, clinical action time and recovery index of muscle relaxation of each group were measured. The mean arterial pressure and heart rate at each time point of anesthesia were recorded and counted. Results No significant difference was found among the four groups in the time when rocuronium started to be effective(P<0.05). The clinical effect of rocuronium in group C and D was longer than that in group A. The recovery indexes of group C and D were higher than those of group A. The differences were statistically significant(P<0.05). Conclusions Dexmedetomidine could enhance the neuromuscular blockade of rocuronium, prolong the clinical aging of rocuronium and increase the recovery index of anesthesia.
Objective To evaluate the effects of dexmedetomidine of different concentration levels on muscle relaxation by rocuronium. Methods 200 patients to be subjected to laparotomy were randomly divided into four groups, namely, group A(n=50), group B(n=50), group C(n=50), and group D(n=50). All groups were subjected to anesthesia with intravenous injection of sufentanil, propofol and rocuronium. Group B, group C, and group D were injected with dexmedetomidine 10 min before injection of sufentanil. The initial doses were 0.3, 0.6, and 1.0 μg/kg, respectively. The maintenance doses were 0.3, 0.6, and 1.0 μg/(g·h). Group A were injected with the same amount of normal saline. The onset time, clinical action time and recovery index of muscle relaxation of each group were measured. The mean arterial pressure and heart rate at each time point of anesthesia were recorded and counted. Results No significant difference was found among the four groups in the time when rocuronium started to be effective(P<0.05). The clinical effect of rocuronium in group C and D was longer than that in group A. The recovery indexes of group C and D were higher than those of group A. The differences were statistically significant(P<0.05). Conclusions Dexmedetomidine could enhance the neuromuscular blockade of rocuronium, prolong the clinical aging of rocuronium and increase the recovery index of anesthesia.
引文
[1] Shoenberger JM,Mallon WK.Rocuronium versus succinylcholine revisited:succinylcholine remains the best choice[J].Ann Emerg Med,2018,71(3):398-399.
[2] Stuker EW,Eskander JP,Gennuso SA.Third time’s a charm:Oral midazolam vs intranasal dexmedetomidine for preoperative anxiolysis in an autistic pediatric patient[J].Paediatr Anaesth,2018,28(4):370-371.
[3] Li J,Chen Q,He X,et al.Dexmedetomidine attenuates lung apoptosis induced by renal ischemia-reperfusion injury through AR/PI3K/Akt pathway[J].J Transl Med,2018,16(1):78.
[4] Jia ZM,Hao HN,Huang ML,et al.Influence of dexmedetomidine to cognitive function during recovery period for children with general anesthesia[J].Eur Rev Med Pharmacol Sci,2017,21(5):1106-1111.
[5] Raineri SM,Cortegiani A,Accurso G,et al.Efficacy and safety of using high-flow nasal oxygenation in patients undergoing rapid sequence intubation[J].Turk J Anaesthesiol Reanim,2017,45(6):335-339.
[6] Sheshadri V,Radhakrishnan A,Halemani K,et al.Infusion dose requirement of rocuronium in patients on phenytoin therapy-A prospective comparative study[J].Indian J Anaesth,2017,61(10):793-797.
[7] Sakai DM,Martin-Flores M,Romano M,et al.Recovery from rocuronium-induced neuromuscular block was longer in the larynx than in the pelvic limb of anesthetized dogs[J].Vet Anaesth Analg,2017,44(2):246-253.
[8] 居奇吉,张立敬.右美托咪定静脉麻醉复合臂丛神经阻滞在上肢手术中的应用[J].健康研究,2014,34(1):91-92,94.
[9] Rajan S,Hutcherson MT,Sessler DI,et al.The effects of dexmedetomidine and remifentanil on hemodynamic stability and analgesic requirement after craniotomy:A randomized controlled trial[J].J Neurosurg Anesthesiol,2016,28(4):282-290
[10] Wu J,Vogel T,Gao X,et al.Neuroprotective effect of dexmedetomidine in a murine model of traumatic brain injury[J].Sci Rep,2018,8(1):4935.
[2] Stuker EW,Eskander JP,Gennuso SA.Third time’s a charm:Oral midazolam vs intranasal dexmedetomidine for preoperative anxiolysis in an autistic pediatric patient[J].Paediatr Anaesth,2018,28(4):370-371.
[3] Li J,Chen Q,He X,et al.Dexmedetomidine attenuates lung apoptosis induced by renal ischemia-reperfusion injury through AR/PI3K/Akt pathway[J].J Transl Med,2018,16(1):78.
[4] Jia ZM,Hao HN,Huang ML,et al.Influence of dexmedetomidine to cognitive function during recovery period for children with general anesthesia[J].Eur Rev Med Pharmacol Sci,2017,21(5):1106-1111.
[5] Raineri SM,Cortegiani A,Accurso G,et al.Efficacy and safety of using high-flow nasal oxygenation in patients undergoing rapid sequence intubation[J].Turk J Anaesthesiol Reanim,2017,45(6):335-339.
[6] Sheshadri V,Radhakrishnan A,Halemani K,et al.Infusion dose requirement of rocuronium in patients on phenytoin therapy-A prospective comparative study[J].Indian J Anaesth,2017,61(10):793-797.
[7] Sakai DM,Martin-Flores M,Romano M,et al.Recovery from rocuronium-induced neuromuscular block was longer in the larynx than in the pelvic limb of anesthetized dogs[J].Vet Anaesth Analg,2017,44(2):246-253.
[8] 居奇吉,张立敬.右美托咪定静脉麻醉复合臂丛神经阻滞在上肢手术中的应用[J].健康研究,2014,34(1):91-92,94.
[9] Rajan S,Hutcherson MT,Sessler DI,et al.The effects of dexmedetomidine and remifentanil on hemodynamic stability and analgesic requirement after craniotomy:A randomized controlled trial[J].J Neurosurg Anesthesiol,2016,28(4):282-290
[10] Wu J,Vogel T,Gao X,et al.Neuroprotective effect of dexmedetomidine in a murine model of traumatic brain injury[J].Sci Rep,2018,8(1):4935.