成人间活体肝移植术中罗库溴铵的药效学研究.pdfVIP

PHARMACODYNAMIC EFFECTS OF ROCURONIUM DURING ADULT-TO-ADULT LIVING DONOR LIVER TRANSPLANTATION ABSTRACT Part one Comparison of Pharmacodynamics of Rocuronium in Adminstration by Target-controlled Infusion verse in Bolus Objective To investigate the pharmacodynamic effects of rocuronium during different stages of adult-to-adult living donor liver transplantation；and evaluate the effects on neuromuscular blockade of rocuronium in bolus or by target-controlled infusion(TCI) in patients with hepatic failure scheduled for adult-to-adult living donor liver transplantation. Methods Twenty-four patients were randomly assigned into group IV(receiving bolus of rocuronium)or group TCI(receiving rocuronium by TCI)during general anesthesia ．The responses of pollex adductor to train-of-four(TOF) stimulation of ulnar nerve were monitored．The time course and doses of rocuronium were recorded．Temperature，blood routine，gas and 4 biochemical changes were monitored during the operation． Results There were no significant differences in onset time，recovery time and total dose requirement of rocuronium between two groups．The clinical acting duration of rocuronium in group IV was 60.17±21.49min in anhepatic phase and 41.42±12.47 min given before hepatic artery reperfusion of neohepatic phase，which was significantly longer than that in preanhepatic phase(40.33±13.08min)．Rocuronium requirement decreased significantly in －1 －1 －1 －1 anhepatic phase (2.1±0.8 μg ·kg ·min and 0.2±0.4 μg ·kg ·min ，in group IV and group TCI，respectively)and in neohepatic phase(2.9±1.5 μg ·kg－1 ·min －1 －1 －1 and 4.2±3.6