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在全身麻醉下使用维库溴铵和罗库溴铵维持术中血流动力学。

Intraoperative hemodynamics with vecuronium bromide and rocuronium for maintenance under general anesthesia.

作者信息

Mathew Alen, Sharma Anish N G, Ganapathi P, Shankaranarayana P, Nazim M, Aiyappa D S

机构信息

Department of Anesthesia, KVG Medical College and Hospital, Sullia, Dakshina Kannada, Karnataka, India.

出版信息

Anesth Essays Res. 2016 Jan-Apr;10(1):59-64. doi: 10.4103/0259-1162.164740.

Abstract

AIMS

The present study is undertaken to compare the hemodynamic effects using vecuronium versus rocuronium for maintenance in patients undergoing general surgical procedures.

SETTINGS AND DESIGN

It is a prospective, randomized, and cohort study.

SUBJECTS AND METHODS

100 patients were randomly divided into two groups. All patients were induced with 5 mg/kg of thiopentone sodium, and intubation conditions were achieved with 1.5 mg/kg of suxamethonium, using a well-lubricated cuffed endotracheal tube of appropriate size. When the patient started to breathe spontaneously, they were administered either 0.6 mg/kg of rocuronium (Group A) or 0.1 mg/kg of vecuronium (Group B). Hemodynamic parameters (heart rate and mean arterial pressure [MAP]) were monitored before administering the drug; at 1, 5, 10, 15, and 20 min after the drug and at the end of the surgery.

STATISTICAL ANALYSIS USED

Data were compiled, analyzed and presented as frequency, proportions, mean, standard deviation, percentages, and t-test using SPSS (version 16). A P < 0.05 was considered as significant.

RESULTS

The heart rate increased significantly at 1-min and 5-min after administration of rocuronium (83.76 ± 10.37 and 86.8 ± 9.98), unlike vecuronium. However, it gradually declined towards normal, and change in heart rate with either drug was not significant beyond 10 min. The MAP decreased significantly at 1-min after administration of rocuronium (96.68 ± 7.57) which later showed a gradual increasing trend when compared to vecuronium which had no statistically significant change at any time.

CONCLUSIONS

For short surgical procedures rocuronium is a good alternative to vecuronium, as the drug is reasonably cardio stable, produces excellent intubation conditions, has a shorter duration of action, and shows minimal cumulative effect.

摘要

目的

本研究旨在比较维库溴铵和罗库溴铵在普外科手术患者维持麻醉时的血流动力学效应。

设置与设计

这是一项前瞻性、随机、队列研究。

研究对象与方法

100例患者随机分为两组。所有患者均用5mg/kg硫喷妥钠诱导麻醉,并用1.5mg/kg琥珀胆碱借助尺寸合适且充分润滑的带套囊气管内导管实现插管条件。当患者开始自主呼吸时,给他们分别静脉注射0.6mg/kg罗库溴铵(A组)或0.1mg/kg维库溴铵(B组)。在给药前、给药后1、5、10、15和20分钟以及手术结束时监测血流动力学参数(心率和平均动脉压[MAP])。

所用统计分析方法

使用SPSS(16版)对数据进行汇总、分析,并以频率、比例、均值、标准差、百分比形式呈现,采用t检验。P<0.05被视为具有统计学意义。

结果

与维库溴铵不同,罗库溴铵给药后1分钟和5分钟时心率显著增加(分别为83.76±10.37和86.8±9.98)。然而,心率随后逐渐降至正常,且10分钟后两种药物引起的心率变化均无统计学意义。罗库溴铵给药后1分钟时MAP显著下降(96.68±7.57),与维库溴铵相比,随后呈现逐渐上升趋势,而维库溴铵在任何时间均无统计学显著变化。

结论

对于短时间手术,罗库溴铵是维库溴铵的良好替代药物。因为该药对心脏相当稳定,能产生良好的插管条件,作用持续时间较短,且累积效应极小。

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