本文選題：七氟醚 + 順式阿曲庫(kù)銨��； 參考：《中南大學(xué)》2014年碩士論文

【摘要】：目的：七氟醚可增強(qiáng)非去極化肌松劑的神經(jīng)肌肉阻滯,既往研究多探討此種協(xié)同作用與七氟醚相關(guān)因素如濃度、作用時(shí)間等的關(guān)系而鮮少研究其與肌松劑劑量之間是否存在關(guān)聯(lián)。在細(xì)胞實(shí)驗(yàn)中發(fā)現(xiàn)七氟醚能夠增強(qiáng)羅庫(kù)溴銨對(duì)乙酰膽堿受體內(nèi)向電流的抑制作用,并且在使用較小劑量的羅庫(kù)溴銨時(shí)更為顯著。本實(shí)驗(yàn)旨在臨床上研究七氟醚對(duì)順式阿曲庫(kù)銨的協(xié)同作用是否與順式阿曲庫(kù)銨的劑量有關(guān),是否有與細(xì)胞實(shí)驗(yàn)結(jié)果類似的在小劑量順式阿曲庫(kù)銨中七氟醚具有更為顯著的協(xié)同作用。 方法：選取全麻下行乳腺改良根治術(shù)患者60例,使用TOF-Watch監(jiān)測(cè)儀監(jiān)測(cè)肌松情況,將患者按所給順式阿曲庫(kù)銨劑量隨機(jī)分入S組(0.10mg/kg)、M組(0.15mg/kg)和L組(0.20mg/kg),各組再按維持全身麻醉方式的不同分為PROP組(丙泊酚4-8ml/kg/h持續(xù)輸注)和SEVO組(七氟醚2MAC持續(xù)吸入)。記錄順式阿曲庫(kù)銨的起效時(shí)間(t0)、維持時(shí)間(tm)、恢復(fù)時(shí)間(tr)與此時(shí)的T1值、手術(shù)結(jié)束至拔除喉罩時(shí)間(tex)及術(shù)前與術(shù)后拔除喉罩20分鐘時(shí)血氧飽和度和術(shù)后Steward蘇醒評(píng)分。 結(jié)果：各組t0時(shí)間差異均無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)；各組SEVO組tm均較PROP組延長(zhǎng)(P0.05)并以S組最為顯著(P0.05)；各組SEVO組tr均較PROP組延長(zhǎng)(P0.05)并以S組最為顯著(P0.05)；各組SEVO組tex均較PROP組延長(zhǎng)(P0.05)；各組術(shù)前與術(shù)后拔除喉罩20分鐘時(shí)血氧飽和度和術(shù)后Steward評(píng)分均無(wú)顯著差異(P0.05)。 結(jié)論：七氟醚可以延長(zhǎng)不同劑量順式阿曲庫(kù)銨的作用時(shí)效,當(dāng)順式阿曲庫(kù)銨的劑量越小時(shí)七氟醚對(duì)其協(xié)同作用越顯著,表22個(gè),圖
[Abstract]:Objective: sevoflurane can enhance neuromuscular block of non-depolarized muscle relaxant. The relationship between the time of action and the dose of muscle relaxant was seldom studied. It was found that sevoflurane could enhance the inhibitory effect of rocuronium on the inward currents of acetylcholine receptor, especially when the dose of rocuronium was lower. The aim of this study was to investigate whether the synergistic effect of sevoflurane on cis-atracurium is related to the dose of cis-atracurium. Whether there is a more significant synergistic effect of sevoflurane in low dose cis-atracurium similar to the results of cell experiments. Methods: 60 patients with modified radical mastectomy under general anesthesia were selected to monitor muscle relaxation with TOF-Watch monitor. Patients were randomly divided into group S (0.10 mg / kg) and group L (0.20 mg / kg) according to the dose of cis-atracurium. Each group was divided into prop group (propofol 4-8ml/kg/h continuous infusion) and sevoxide group (sevoflurane 2MAC continuous inhalation) according to the maintenance of general anesthesia. The onset time, maintenance time, recovery time and T1 value of cis atracurium were recorded. The time from operation to removal of larynx mask was recorded. The oxygen saturation of blood and Steward's recovery score after operation and 20 minutes after removal of laryngeal mask were recorded. Results: there was no significant difference in the time of t0 in each group (P 0.05); the tm of each group was longer than that of prop group (P 0.05), especially in S group (P 0.05); the tr of each group was longer than that of prop group (P 0.05), and the most significant difference was that of group S (P 0.05); the tex of each group was longer than that of Prop group (P 0.05). There was no significant difference in blood oxygen saturation and Steward score before and after laryngeal mask removal in each group (P 0.05). Conclusion: sevoflurane can prolong the effect of different doses of cis-atracurium. The more dose of cis-atracurium, the more significant the synergistic effect of sevoflurane is.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R614

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 溫麗麗;林文前;招偉賢;李國(guó)才;白曉暉;肖建斌;;兩種麻醉方式對(duì)持續(xù)輸注順式阿曲庫(kù)銨肌松效應(yīng)的影響[J];南方醫(yī)科大學(xué)學(xué)報(bào);2010年01期

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本文編號(hào)：2048472