浅低温对麻醉恢复期患者顺式阿曲库铵肌松恢复的影响.pdf

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1、中华麻醉学杂志2014年3月第34卷第3期ChinJAnesthesiol，March2014，Vo1．34，No．3·全身麻醉·浅低温对麻醉恢复期患者顺式阿曲库铵肌松恢复的影响周一张欢杨拔贤【摘要】目的评价浅低温对麻醉恢复期患者顺式阿曲库铵肌松恢复的影响。方法择期全麻下行开腹手术患者30例，性别不限，年龄18—64岁，体重指数18～25kg／m~，ASA分级I或Ⅱ级。根据术毕停止输注顺式阿曲库铵时患者体温分为2组：体温36．0～36．9℃为正常体温组(N组，n=14)和体温34．0～35．9℃为浅低温组(H组，n=1

2、6)。采用TOF-Watchs加速度肌松监测仪监测肌松情况，采用四个成串刺激模式，频率为2Hz，波宽为0．2ms，电流强度为50mA，刺激间隔为15s。术中静脉输注顺式阿曲库铵1—3tLg·kg～·min～，维持1％

3、复期患者顺式阿曲库铵的肌松恢复。【关键词】低温，人工；麻醉恢复期；阿曲库铵；神经肌肉阻滞EfectofmildhypothermiaonrecoveryfromcisatracuriumblockadeduringrecoveryfromanesthesiaZhouYi，ZhangHuan，YangBaxian．DeportmentofAnesthesiology，PekingUniversityPeople’sHospital，Beijing100044，ChinaCorrespondingauthor：ZhangH

4、uan，Email：zhanghuan60175@hotmail．corn【Abstract】ObjectiveToevaluatetheefectofmildhypothermiaontherecoveryfromcisatracuriumblockadeduringtherecoveryfromanesthesiainpatients．MethodsThirtyASAphysicalstatus1or1Ipatients，aged18—64yr，withbodymassindex18—25kg／Ⅱf，schedul

5、edforelectiveabdominalsurgeryundergeneralanesthesia，wereenroHedinthestudy．Thepatientsweredividedinto2gmupsaccordingtothebodytemperaturerecordedwhencisatracuriuminfusionwasstoppedattheendofsurgery．Thebodytemperature36．0—36．9℃servedasnormothenniagroup(groupN，n=14)

6、and34．0—35．9℃servedasmildhypothermiagroup(groupH，n=16)．Thebodytemperaturewasmeasuredbyathermocoupleplacedinthenasopharynx．Neuromuscularfunctionwasmonitoredbymeasuringtheevokedmechanicalresponseoftheadductorpollicismuscletosupramaximaltrain-of-four(TOF)stimulatio

7、n(frequency2Hz，wavelength0．2ms，intensity50mA，interval15s)oftheulnarnerveatthewristusingTOF-WatchsX．Cisatracuriumwasintmvenouslyinfusedat1-3‘kg‘minduringsurgerytomaintainneuromuscularblockwith1％

8、urgery．Therecoveryindex(timeforTitorecoverfrom25％to75％)，timefl0rTItorecoverfrom10％to75％，andtimefor1’ltorecoverfrom10％toT4／Tlratioof0．9wererecorded．ResultsComparedwith