Nagase Kiyoshi, Iida Hiroki
Operation Division, Gifu University Hospital, Gifu 501-1194.
Masui. 2012 Mar;61(3):292-8.
It is recommended to minimize neuromuscular blocker administration during general anesthesia for the efficacy of operating room utilization and potential hazards of unintended awareness during anesthesia.
We retrospectively compared the dose of vecuronium in consecutive 8,007 patients under general anesthesia receiving remifentanil or fentanyl. In analyzing electronic anesthesia records over 4 years in a single university institute, we also examined the type of general anesthesia and the required time of each pro- cedure in the operating room.
Less vecuronium was necessary in patients administered remifentanil than those given fentanyl both maintained with inhalational and intravenous anesthesia. Supplementation with epidural anesthesia did not influence the dose of vecuronium in patients under general anesthesia receiving remifentanil or fentanyl. We also measured the time necessary before extubating trachea after finishing surgery, while no difference was found between the patients recieving remifentanil and fentanyl.
Anesthesia with remifentanil reduces requirement of vecuronium dose greater than with fentanyl, while it does not affect the emergence time from anesthesia.
为提高手术室利用率并降低麻醉期间意外知晓的潜在风险，建议在全身麻醉期间尽量减少神经肌肉阻滞剂的使用。
我们回顾性比较了连续8007例接受瑞芬太尼或芬太尼全身麻醉患者的维库溴铵剂量。在分析一所大学机构4年的电子麻醉记录时，我们还检查了全身麻醉的类型以及手术室中每个手术步骤所需的时间。
在吸入麻醉和静脉麻醉维持下，接受瑞芬太尼的患者所需维库溴铵比接受芬太尼的患者少。在接受瑞芬太尼或芬太尼全身麻醉的患者中，硬膜外麻醉辅助并未影响维库溴铵的剂量。我们还测量了手术后气管拔管前所需的时间，接受瑞芬太尼和芬太尼的患者之间未发现差异。
与芬太尼相比，瑞芬太尼麻醉降低了维库溴铵的剂量需求，但不影响麻醉苏醒时间。
