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目的 研究连续泵注莱库溴铵在地氟醚、七氟醚、异氟醚和异丙酚麻醉下的肌松作用及安全性。方法 80例ASAⅠ～Ⅲ级择期手术病人 ,使用TOF GUARD监测仪监测肌松。麻醉诱导静注异丙酚 1 5～ 3mg kg、芬太尼 1～ 2 μg kg、莱库溴铵 1 5mg kg ,气管插管机械通气。维持麻醉时 ,随机吸入呼气终末浓度为 2 %～ 4%地氟醚、0 75 %～ 1 5 %七氟醚或 0 4%～ 0 8%异氟醚 ,或静脉泵注异丙酚 75～ 2 0 0 μg·kg 1 ·min 1 。T1 恢复至 5 %时静脉泵注莱库溴铵 3mg kg 1 h 1 ,调节泵速维持 90 %阻滞 ,持续泵注 45～ 6 0min。结果 4个麻醉组间年龄、身高、体重、莱库溴铵的单次静注用量、静脉输注总量、输注速率、输注时间、结束莱库溴铵输注后T1 恢复至 2 5 %、5 0 %、75 %和 90 %的时间、T4 T1 恢复至 70 %和 80 %的时间及肌松恢复指数 ,均无差异 (P >0 0 5 )。在结束莱库溴铵输注后T1 恢复至 90 %的时间是 34～ 5 7min ,肌松恢复指数为 2 4～ 2 9min。未见与组胺释放相关的临床指征。结论 在地氟醚、七氟醚、异氟醚和异丙酚麻醉下莱库溴铵能提供安全有效的肌松作用 ,但输注45～ 6 0min后莱库溴铵的肌松作用从短效变成中效。
Objective To study the muscle relaxant effect and safety of continuous pump injection of lekabuponium on desflurane, sevoflurane, isoflurane and propofol anesthesia. Methods 80 cases of ASA Ⅰ ~ Ⅲ grade elective surgery patients, the use of TOF GUARD monitor muscle relaxation. Induction anesthesia intravenous propofol 15 ~ 3mg kg, fentanyl 1 ~ 2 μg kg, Lithium bromide 15mg kg, endotracheal intubation mechanical ventilation. Maintaining anesthesia, random inhalation of end-expiratory concentrations of 2% to 4% desflurane, 0 75% to 15% sevoflurane or 0 4% to 0 8% isoflurane, or intravenous propofol 75 ~ 200 μg · kg 1 · min 1. T1 recovery to 5% when intravenous lecuronium bromide 3mg kg 1 h 1, adjust the pump speed to maintain 90% block, continuous pump 45 ~ 60min. Results The age, height, weight, single intravenous dose of lekuronium, total intravenous infusion, infusion rate and infusion time in the four anesthesia groups and T1 after the end of lekuronium infusion ended to 25 %, 50%, 75% and 90% of the time. There was no difference between T4 T1 recovery to 70% and 80% recovery time and muscle relaxation recovery index (P> 0.05). T1 to 90% of the time after the end of delivery of raloxifene infusion is 34 ~ 57min, muscle relaxation recovery index was 24 ~ 29min. No clinical indications associated with histamine release were found. Conclusions Lekuronium bromide provides a safe and effective muscle relaxant effect after desflurane, sevoflurane, isoflurane and propofol anesthesia, but the muscle relaxant effect of lekuronium from 45 to 60 min after infusion Effectiveness becomes effective.