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罗库溴铵在气管插管及肌松维持中的作用 |
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张秀华 洪溪 郭向阳 任洪智 罗爱伦
（100730 中国医学科学院中国协和医科大学北京协和医院麻醉科）
【摘要】 目的 观察静脉注射罗库溴铵时的气管插管条件、维持肌松过程和恢复过程，及其对循环的影响。方法 将32例择期手术病人，随机分为两组：Ⅰ组、Ⅱ组病人分别于静脉注射罗库溴铵后60和90秒钟进行气管插管。完成插管后将病人再分为两组(Ⅲ、Ⅳ组)，Ⅲ组间断静脉注射罗库溴铵维持肌松，Ⅳ组连续滴注罗库溴铵维持肌松。结果 静脉注射罗库溴铵0.6 mg/kg(2×ED95)后60秒钟和90秒钟时的气管插管条件均为优良，神经肌肉阻滞程度分别是T1为(23±22)%，T4/T1为(27±28)%（60秒钟）和T1为(6±10)%，T4/T为(17±19)%（90秒钟），起效时间为2.3分钟。静脉注射罗库溴铵后心率、血压平稳。结论 静注罗库溴铵(0.6 mg/kg)后60～90秒钟均可为气管插管提供满意的肌松，术中间断静注或连续滴注均可维持满意的手术肌松，恢复过程无明显差别。
【关键词】 肌松弛剂，中枢性 插管法，气管内 麻醉，全身
Evaluation of the intubating conditions and maintenance doses of rocuronium Zhang Xiuhua, Hong Xi, Guo Xiangyang,et al. Department of Anesthesia, PUMC Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730
【Abstract】 Objective To assess intubating conditions after administration of rocuronium 0.6mg/kg at 60 or 90 s and neuromuscular blocking effects of rocuronium. Methods Thirty-two patients were randomly designated to two groups: 60 s group and 90 s group. Anesthesia consisted of thiopentone, fentanyl,N2O/O2 and enflurane. After a 2×ED95 dose the trachea was intubated at 60 or 90s and the intubating conditions were recorded. After intubation was finished, patients were allocated randomly to receive either intravenous infusion or bolus injection of rocuronium to maintain surgical relaxation.Results Intubating conditions were not different between the two groups and were found to be clinically acceptable (good or excellent) in all patients. The maintenance of surgical relaxation was satisfactory either with repeated bolus and infusion of rocuronium. Conclusion Intubation can be performed under good to excellent conditions within 60～90 seconds after a bolus dose of 0.6mg/kg rocuronium.This indicates that rocuronium may be a suitable alternative to succinycholine during rapid-sequence induction of anesthesia.
【Key words】 Muscle relaxants, central Endotrac[1] [2] 下一页
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