So Keum Young, Kim Sang Hun, Jung Ki Tae, Kim Dong Woo
Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju, Korea.; Department of Anesthesiology and Pain Medicine, Chosun University, School of Medicine, Gwangju, Korea.
Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Gwangju, Korea.
Korean J Anesthesiol. 2017 Apr;70(2):163-170. doi: 10.4097/kjae.2017.70.2.163. Epub 2017 Jan 12.
The effect of dexamethasone injection on cisatracurium-induced neuromuscular block was compared according to different injection time points.
One hundred seventeen patients were randomly assigned to three groups: 8 mg of dexamethasone injected intravenously 2-3 h before anesthesia (group A), just before anesthesia induction (group B), and at the end of surgery (control group). Three minutes after anesthesia induction, intubation was performed without neuromuscular blockers, and acceleromyography was initiated. All patients received 0.05 mg/kg cisatracurium; the onset time and recovery profiles were recorded.
Eighty patients were finally enrolled. The onset time (median [interquartile range], seconds) was significantly hastened in group A (520.0 [500.0-560.0], n = 30) compared to that in group B (562.5 [514.0-589.0], n = 22) (P = 0.008) and control group (586.5 [575.0-642.5], n = 28) (P < 0.001). The onset time in group B was faster than the control group (P = 0.015). The recovery time [mean (95% CI) minutes] was significantly hastened in group A [28.5 (27.3-29.6)] compared to that in group B [32.3 (31.0-33.6)] (P < 0.001) and control group [30.9 (29.9-31.8)] (P = 0.015). The total recovery time was significantly hastened more in group A [47.1 (45.5-48.6)] than group B [52.8 (51.6-54.0) minutes] (P < 0.001) and control group [50.5 (48.7-52.3) minutes] (P = 0.008).
A single dose of 8 mg of dexamethasone hastened the onset and total recovery times of cisatracurium-induced block by approximately 15 and 9%, respectively if administered 2-3 h prior to surgery.
根据不同的注射时间点，比较地塞米松注射液对顺式阿曲库铵诱导的神经肌肉阻滞的影响。
117例患者被随机分为三组：麻醉前2 - 3小时静脉注射8毫克地塞米松（A组）、麻醉诱导前即刻注射（B组）以及手术结束时注射（对照组）。麻醉诱导后3分钟，在不使用神经肌肉阻滞剂的情况下进行气管插管，并启动加速度肌电图监测。所有患者均接受0.05毫克/千克顺式阿曲库铵；记录起效时间和恢复情况。
最终纳入80例患者。与B组（562.5 [514.0 - 589.0]，n = 22）（P = 0.008）和对照组（586.5 [575.0 - 642.5]，n = 28）（P < 0.001）相比，A组（520.0 [500.0 - 560.0]，n = 30）的起效时间（中位数[四分位间距]，秒）显著加快。B组的起效时间比对照组快（P = 0.015）。与B组[32.3 (31.0 - 33.6)]（P < 0.001）和对照组[30.9 (29.9 - 31.8)]（P = 0.015）相比，A组[28.5 (27.3 - 29.6)]的恢复时间[平均值(95%可信区间)，分钟]显著加快。A组[47.1 (45.5 - 48.6)]的总恢复时间比B组[52.8 (51.6 - 54.0)分钟]（P < 0.001）和对照组[50.5 (48.7 - 52.3)分钟]（P = 0.008）显著加快更多。
如果在手术前2 - 3小时给予单剂量8毫克地塞米松，可分别使顺式阿曲库铵诱导的阻滞起效时间和总恢复时间加快约15%和9%。
