温度的变化会引起一系列生理代谢及器官功.docVIP

PAGE PAGE 4 作者介绍 吴敏仙 女 上海市交通大学医学院附属第一人民医院研究生 上海市曙光医院宝山分院 通讯作者 李士通 男 上海市交通大学医学院附属第一人民医院 200080 体温对老年人顺式阿曲库铵与罗库溴铵恢复时相影响的比较 吴敏仙 李士通 【摘要】目的：比较不同体温对老年病人术后顺式阿曲库铵和罗库溴铵肌松恢复的影响。方法：择期全麻手术老年患者80例，随机分为4组，分别为A、B、C、D组，每组20例，A、B组给予顺式阿曲库铵，C、D组给予罗库溴铵， A、C组为非保温组，术中不采取特殊保温措施，B、D组为保温组，用保温毯进行保温。采用全身麻醉联合硬膜外麻醉，全麻诱导插管用顺式阿曲库铵0.15 mg／kg或罗库溴铵0.6 mg／kg，术中肌松药静脉泵注维持，持续监测肌松和鼻咽温度，记录起效时间、累积剂量、手术时间、T1恢复至25％ 、50％ 、75％ 、TOFR恢复至90％的时间以及麻醉诱导时、T1恢复至25％时、TOFR恢复至90%时的温度。结果：术毕非保温组病人（A与C组）体温明显下降，与保温组病人（B与D组）比较差异显著(P0.01)。顺式阿曲库铵组的起效时间长于罗库溴铵组(P0.01)，而肌松恢复指数（ T1自25%恢复至75%的时间）明显短于罗库溴铵组(P0.01)，保温组完全恢复时间（T1自25%到TOFR恢复至90%的时间）也短于罗库溴铵组(P0.01) 。同一肌松药保温组病人起效时间没有明显差异，而肌松恢复指数和完全恢复时间均短于非保温组(P0.05)，顺式阿曲库铵组更加明显(P0.01)。结论：老年病人容易发生术中低体温，保温有助于肌松的恢复，特别是顺式阿曲库铵。 【关键词】顺式阿曲库铵；罗库溴铵；老年病人；体温；肌松恢复 A comparison of the effect of body temperature on the relaxation recovery of cisatracurium and rocuronium in elder patients. WU Min-xian ,lI Shi-tong 【Abstract】Objective：To investigate the effect of body temperature on the relaxation recovery of cisatracurium and rocuronium in elder patients. Methods： Eighty elder patients undergoing elective surgery were randomly divided into one of the following groups: muscle relaxation was maintained with cisatracurium in Group A and B; and with rocuronium in groups C and D respectively. Body temperature was preserved with a heat-protecting blanket in Group B and D .Group A and Group C were set as control. All patients received general anaesthesia combined with epidural anaesthesia. Intubation was conducted with cisatracurium 0.15 mg／kg or rocuronium 0.6 mg／kg according to the grouping. Muscle relaxants were infused by a pump during the operation. The parameters of temperature and muscle relaxation were recorded during the whole procedure, including: the onset time and total dosage of the relaxant; duration of the operation, durations of T1 recovery to 25%、 50%、 75%; durations of TOFR recovery to 25% 、50% 、75%; the nasopharyngeal temperatures at induction, 25% T1 recovery,90% TOFR recovery .