单肺通气期间维库溴铵诱导的神经肌肉阻滞监测

Monitoring of vecuronium-induced neuromuscular blockade during one-lung ventilation.

作者信息

Saitoh Yuhji, Oshima Tsutomu, Nakata Yoshinori

机构信息

Department of Anesthesiology, Satte General Hospital, 4-14-24 Higashi, Satte, Saitama, 340-0114, Japan.

出版信息

J Anesth. 2008;22(4):378-84. doi: 10.1007/s00540-008-0666-7. Epub 2008 Nov 15.

DOI:10.1007/s00540-008-0666-7

PMID:19011776

Abstract

PURPOSE

We investigated the monitoring of neuromuscular blockade caused by vecuronium in patients receiving one-lung ventilation (OLV) anesthesia for lung surgery.

METHODS

Eighteen adult patients requiring OLV for lung surgery (OLV group) and 18 undergoing two-lung ventilation (TLV) for colon surgery (control group) were enrolled in this study. In the two groups, anesthesia was maintained with sevoflurane, fentanyl, and epidural lidocaine. Time from vecuronium 0.1 mg.kg(-1) to the onset of neuromuscular blockade; times to the return of T1, T2, T3, or T4 (the first, second, third, or fourth response of the train-of-four [TOF]); and recovery of T1/control or TOF ratio (T4/T1) were compared between the two groups.

RESULTS

Time to the onset of neuromuscular blockade in the OLV group was similar to that in the control group (289 +/- 74 vs 270 +/- 85 s [mean +/- SD]; P = 0.482). Times from vecuronium to the return of T1, T2, T3, or T4 in the OLV group did not significantly differ from those in the control group (21.9 +/- 7.0 vs 25.8 +/- 6.7 min for T1; P = 0.099). T1/control in the OLV group was significantly higher than that in the control group 50-120 min after vecuronium (P < 0.05). The TOF ratio did not differ significantly between the two groups.

CONCLUSION

During OLV for lung surgery, recovery of T1/control is accelerated in anesthetized patients receiving vecuronium.

摘要

目的

我们研究了在接受肺手术单肺通气（OLV）麻醉的患者中维库溴铵引起的神经肌肉阻滞监测情况。

方法

本研究纳入了18例因肺手术需要OLV的成年患者（OLV组）和18例因结肠手术接受双肺通气（TLV）的患者（对照组）。两组均采用七氟醚、芬太尼和硬膜外利多卡因维持麻醉。比较维库溴铵0.1mg·kg⁻¹给药至神经肌肉阻滞起效的时间；T1、T2、T3或T4恢复的时间（四个成串刺激[TOF]的第一、第二、第三或第四次反应）；以及两组之间T1/对照或TOF比值（T4/T1）的恢复情况。

结果

OLV组神经肌肉阻滞起效时间与对照组相似（289±74 vs 270±85秒[平均值±标准差]；P = 0.482）。OLV组从维库溴铵给药至T1、T2、T3或T4恢复的时间与对照组相比无显著差异（T1为21.9±7.0 vs 25.8±6.7分钟；P = 0.099）。维库溴铵给药后50 - 120分钟，OLV组的T1/对照显著高于对照组（P < 0.05）。两组之间的TOF比值无显著差异。