[1]徐懋,杨拔贤*,张利萍①.硝酸甘油控制性低血压对罗库溴铵药效学的影响[J].中国微创外科杂志,2008,08(3):235-237.
　Xu Mao*,Yang Baxian*,Zhang Liping..Influence of Nitroglycerininduced Deliberate Hypotension on Pharmacodynamics of Rocuronium[J].Chinese Journal of Minimally Invasive Surgery,2008,08(3):235-237.
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硝酸甘油控制性低血压对罗库溴铵药效学的影响()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
08
期数:
2008年3期
页码:
235-237
栏目:
出版日期:
2008-10-25

文章信息/Info

Title:
Influence of Nitroglycerininduced Deliberate Hypotension on Pharmacodynamics of Rocuronium
作者:
徐懋; 杨拔贤*; 张利萍①
北京大学人民医院麻醉科，北京100044
Author(s):
Xu Mao*;  Yang Baxian*;  Zhang Liping.
*Department of Anesthesiology, Peking University People’s Hospital, Beijing 100044, China
关键词:
硝酸甘油; 控制性低血压; 罗库溴铵; 药效学
Keywords:
Nitroglycerin; Pharmacodynamics; Rocuronium; Deliberate hypotension
分类号:
R614.2
文献标志码:
A
摘要:
目的探讨硝酸甘油控制性低血压对罗库溴铵量效关系和恢复时程的影响。方法50例全麻下择期手术，按手术顺序编号，采用随机数字表法分为控制性低血压(deliberate hypotension,DH)组和对照组，每组25例。采用四个成串刺激（TOF刺激）方式监测拇内收肌的收缩反应，记录麻醉手术期间罗库溴铵累计给药法的量效关系（ED50、ED90和ED95，即TOF中第一个肌颤搐（T1%）达到50%、90%和95%抑制所需剂量），追加药物时间间隔、峰效应时间、临床作用时间、作用总时间和恢复指数。结果DH组的ED50、ED90和ED95分别为（141.9±34.7）、（260.8±64.5）和（337.1±81.5）μg/kg，明显低于对照组［分别为（179.8±35.3）、（330.4±72.0）和（401.8±99.5）μg/kg］（t=3.828,P=0.000;t=3.600,P=0000;t=2.515,P=0.015）。DH组量效关系曲线的截距为-4.6±1.2，明显高于对照组-5.7±1.3（t=3.109,P=0.003）。与对照组比较，DH组达到最大抑制效应的时间较长［（2.8±0.6）min vs（2.4±0.5）min,t=2.561,P=0.014］。DH组追加药物的维持时间和恢复时程的峰效应时间、临床作用时间和作用总时间比对照组长，但是差异无显著性(P＞0.05)。结论罗库溴铵在硝酸甘油控制性低血压时临床作用强化，起效减慢，但其恢复时程无显著变化。
Abstract:
ObjectiveTo study the influence of nitroglycerininduced deliberate hypotension on the doseeffect relationship and time course of recovery of rocuronium. MethodsA total of 50 patients scheduled for elective surgery were numbered consecutively and randomly assigned to deliberate hypotension (DH) or control group (n=25 for each). Thumb adductorius contractile response was monitored with TOF stimulation and the percentage of T depression response was studied. The doseresponse relationship of rocuronium was determined by cumulative doseresponse technique. The doses of rocuronium required for 50%, 90% and 95% T1 depression (ED50, ED90, and ED95), interval between rocuronium injections, peakeffect time, clinical effective time, total effective time, and the timecourse of recovery of muscle relaxation were recorded.ResultsThe ED50, ED90, and ED95 were (141.9±34.7), (260.8±64.5) and (337.1±81.5) μg/kg respectively in DH group， which were significantly lower than those in the control ［(179.8±35.3), (330.4±72.0), and (401.8±99.5) μg/kg, respectively; t=3.828, P=0.000; t=3.600, P=0000; t=2.515, P=0.015］. The intercept of the doseresponse relationship curve in DH group was significantly longer than that in the control (-4.6±1.2 vs -5.7±1.3, t=3.109, P=0.003). Compared with the control, the time for maximum depression in DH group was significantly longer ［(2.8±0.6) min vs (2.4±0.5) min, t=2.561, P=0.014］. The effective time of superadded injection, peakeffect time of course of recovery, clinical effective time, and total effective time in DH group were longer than those in the control, however, no significant differences were detected(P＞0.05). ConclusionsThe effect of rocuronium can be potentiated by nitroglycerininduced deliberate hypotension, while time for maximum depression is prolonged.However, the time course of recovery of rocuronium can not be affected markedly.

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备注/Memo

备注/Memo:
*通讯作者，①（北京大学第三医院麻醉科，北京100083
更新日期/Last Update: 2013-10-22