麻醉药物：吸入麻醉药的肌松协同作用

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摘要译文（供参考） 七氟烷和地氟烷对腹腔镜结肠癌手术中肌松剂维库溴铵的协同作用的比较 

目的 

七氟醚和地氟烷是临床上常用的吸入麻醉药。 本研究比较了七氟烷和地氟烷在腹腔镜结肠癌手术中对毒蕈碱类药物维库溴铵的协同作用。 本研究的目的是比较七氟烷和地氟醚在腹腔镜结肠癌手术中对肌松剂维库溴铵的协同作用。 

方法 

60例择期腹腔镜结肠癌根治术患者随机分为七氟烷组（n=30）和地氟烷组（n=30）。 麻醉和气管插管成功后，两组患者均使用联合瑞芬太尼。 使用肌肉松弛剂监测器（train of stimuli-Watch成串刺激监测仪）监测两组的肌肉松弛效果，观察开始时间、T1和T2恢复时间以及维库溴铵的剂量。 观察两组的血流动力学变化，并记录血管活性药物的剂量。 使用简易智力状态检查量表（MMSE）和Aldrete评分标准评估患者的康复质量。 

结果 

两组维库溴铵起效时间无显著性差异（P>0.05）。 地氟烷组的T1和T2恢复时间晚于七氟醚组。 地氟烷组的维库溴铵的剂量显著低于七氟烷组（P<0.05）； 地氟醚组拔管时间明显长于七氟醚组（P<0.05）。 两组术前和术中平均动脉压、心率、麻黄碱和阿托品剂量、MMSE评分和Aldrete评分无显著差异（P>0.05）。 

结论 

与七氟烷相比，地氟烷对维库溴铵的肌肉松弛剂具有更强的协同作用，而不会增加心血管不良反应的发生率并影响患者康复。

图1.患者招募流程图。

图2.不同时间点心率（HR）和平均动脉压（MAP）的变化。 （A） HR和（B）MAP。

图3.七氟烷和地氟醚组的T1和 T2恢复时间。

图4.两组肌松剂的起效和肌松剂剂量。

Comparison of the synergistic effects of sevoflurane and desflurane on muscle relaxant vecuronium in laparoscopic colon cancer surgery Sevoflurane and desflurane are commonly used inhalation anesthetics in clinical practice. This study compared the synergistic effects of sevoflurane and desflurane on the muscarinic agent vecuronium in laparoscopic colon cancer surgery. The aim of this study was to compare sevoflurane and desflurane in a synergistic effect on the muscle relaxant vecuronium in laparoscopic colon cancer surgery. Sixty patients undergoing elective laparoscopic radical resection of colon cancer were randomly divided into sevoflurane (n = 30) and desflurane (n = 30) groups. After anesthesia and successful tracheal intubation, patients in both groups were maintained with combined remifentanil. Muscle relaxant effects were monitored in both groups using a muscle relaxant monitor (train of stimuli-Watch), the onset time, T1 and T2 recovery time, and muscle relaxant dosage of vecuronium were observed. Hemodynamic changes were observed in both groups, and the dosage of vasoactive drugs was recorded. The quality of recovery of the patients was evaluated using the Mini-Mental State Examination (MMSE) and the discharge from the Aldrete score criteria. There was no significant difference in the onset time of vecuronium between the two groups (P > .05). The desflurane group's T1 and T2 recovery times were later than that of the sevoflurane group. The dosage of vecuronium was statistically significantly less than that in the sevoflurane group (P < .05); the extubation time in the desflurane group was statistically significantly longer than that in the sevoflurane group (P < .05). There were no significant differences in preoperative and intraoperative mean arterial pressure, heart rate, ephedrine and atropine dosage, MMSE score, and Aldrete score between the 2 groups (P > .05). Compared with sevoflurane, desflurane has a stronger synergistic effect on the muscle relaxant of vecuronium without increasing the incidence of cardiovascular adverse reactions and affecting patient recovery. Figure 1. Flow chart of patient’s recruitment. Figure 2. Changes in heart rate (HR) and mean arterial pressure (MAP) at different time points. (A) HR and (B) MAP. Figure 3. T1 and T2 recovery time between in groups of sevoflurane and desflurane. Figure 4. The onset of muscle relaxant and dose of muscle relaxant in the two groups.                             

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编辑：MiLu.米鹭

校对：Michel.米萱

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