标题：低温体外循环对婴幼儿顺式阿曲库铵肌松作用的影响

      作者：罗 琳，王颖林，田国刚
    （海南省海口市人民医院中南大学湘雅医学院附属海口医院麻醉科，海南 海口 570208）

      卷次： 2013年24卷11期

      【摘要】 目的 探讨低温体外循环(CPB)对婴幼儿顺式阿曲库铵肌松作用的影响。方法 选择4个月~3岁
先天性心脏病患儿(左向右分流) 30例，ASA分级Ⅱ或Ⅲ级。监测四次成串刺激(TOF)，全麻诱导给予顺式阿曲库
铵 0.15 mg/kg，肌颤搐反应强度(T1)最大程度抑制时进行气管插管。T1恢复至 75%时静脉注射顺式阿曲库铵
0.05 mg/kg。术中观测患儿红细胞压积(Hct)、pH值及体温等；记录CPB前、CPB中和CPB后三阶段T1分别恢复到
10%、25%和75%所需时间 (T1 10%、T1 25%、T1 75%)及恢复指数(T1 25%到T1 75%之间的时间)。结果 与CPB
之前相比，Hct在CPB中和CPB后降低(P<0.05)；pH值在CPB前、中和后差异无统计学意义(P>0.05)；CPB中的最
低温度低于CPB前(P<0.05)，在CPB后温度与CPB前比较差异无统计学意义(P>0.05)。低温CPB中顺式阿曲库
铵的T1 10%、T1 25%较CPB前延长(P<0.05)；CPB后顺式阿曲库铵的T1 10%、T1 25%、T1 75%及恢复指数均较
CPB前延长(P<0.05)。结论 在婴幼儿低温体外循环中顺式阿曲库铵的作用时间延长、恢复延迟，且在CPB后仍
不能恢复至CPB前的水平。

      【关键词】 顺式阿曲库铵；低温体外循环；婴幼儿；TOF比值

      【中图分类号】 R726.1 【文献标识码】 A 【文章编号】 1003—6350（2013）11—1611—03


Effect of hypothermic cardiopulmonary bypass on the neuromuscular blocking potency of cisatracurium in
infants.
LUO Lin, WANG Ying-lin, TIAN Guo-gang. Department of Anesthesiology, Haikou People's Hospital, Haikou
Hospital Affiliated to Xiangya School of Medicine, Central South University, Haikou 570208, Hainan, CHINA

【Abstract】 Objective To investigate the influence of hypothermic cardiopulmonary bypass (CPB) on the
neuromuscular blocking potency of cisatracurium in infants. Methods Thirty ASAⅡ~Ⅲ children with congenital
heart disease, aged 4 months to 3 years, were chosen. Train-of-four (TOF) was used for evaluating the potency of neu-
romuscular block. Cisatracurium (0.15 mg/kg) was administered and then tracheal intubation was performed when T1
was depressed the most. When T1 of TOF ascended to 75% of base line, cisatracurium of 0.05 mg/kg was supplement-
ed. The values of intraoperative hematocrit (Hct), pH and temperture were recorded. The duration (T1 10% , 25% ,