麻黄碱复合利多卡因对顺式阿曲库铵肌松效应的影响

目的比较麻黄碱预处理、利多卡因预处理和麻黄碱复合利多卡因预处理对顺式阿曲库铵起效时间、插管条件及其血流动力学的影响。方法选择全麻下行择期手术的患者120例随机分为4组,Ⅰ组生理盐水0.5ml,Ⅱ组麻黄碱70μg/kg,Ⅲ组利多卡因1.5mg/kg,Ⅳ组麻黄碱复合利多卡因70μg/kg+1.5mg/kg,预处理3min后4组患者均静脉注射顺式阿曲库铵0.15mg/kg,在5s内注射完成。患者入睡后行肌松监测,使用4个成串刺激(TOF),待T1达最大抑制程度时行气管插管,记录肌松起效时间,评估气管插管条件,同时观察HR、BP的变化。结果Ⅱ、Ⅲ、Ⅳ组肌松起效时间明显短于Ⅰ组(P0.05),而且Ⅳ组起效时间较Ⅱ、Ⅲ组短(P0.05);Ⅱ、Ⅲ、Ⅳ组气管插管优良率高于Ⅰ组(P0.05),但Ⅱ、Ⅲ组气管插管优良率比较无统计学意义;各组麻醉诱导期间均无明显心血管不良反应。结论麻黄碱复合利多卡因70μg/kg+1.5mg/kg预处理为较好的选择。

Effect of ephedrine and lydocaine on muscle relaxant effect of cisatracurium

Objective To investigate the effect of ephedrine and lydocaine on the intubating condition and onset time of cisatracurium . Methods 120 consecutive patients undergoing general anesthesia were randomly assigned to one of 4 groups .All patients were injected one of normal saline （group Ⅰ ） ,ephedrine 70 μg/kg （group Ⅱ ） , lydocaine 1.5 mg/kg （group Ⅲ） and combination of ephedrine 70 μg/kg ,and lydocaine 1.5 mg/kg （group Ⅳ） di‐luted into a 5 ml solution ,followed 3 minutes later by cisatracurium 0.15 mg/kg in all groups .Onset time was re‐corded the electromyographical responses using single twitch and intubating conditions were evaluated at 60 sec‐onds after cisatracurium administration . Results The mean onset time was most significantly accelerated in group Ⅳ and was also significantly more accelerated in group Ⅱ ,Ⅲ and Ⅳ compared with group Ⅰ （P〈0.05） .In‐tubating conditions were significantly improved in group Ⅱ ,Ⅱ and Ⅳ than group Ⅰ （P〈0.05） . Conclusion The combination of phedrine 70 μg/kg ,and lydocaine 1.5 mg/kg accelerated the onset time and was improved the intubating conditions .