鎂對羅庫溴銨肌松作用的影響

鎂動力 分類: 科研 發布時間: 2020-09-14 15:50

羅庫溴銨是臨床常用的肌松藥,其效果受到諸多因素的影響,對這些影響因素的深入研究有助于提高臨床麻醉安全性,這篇發表在Eur J Anaesthesiol雜志上的文章Effects of magnesium on the dose of rocuronium for deep neuromuscular blockade: A randomised controlled trial闡述了鎂對羅庫溴銨肌松劑量的影響。

鎂對羅庫溴銨深度神經肌肉阻滯劑量的影響:一項隨機對照試驗

背景:眾所周知,鎂能增強羅庫溴銨的作用,但其程度尚未量化。

目的:探討鎂對羅庫溴銨深度神經肌肉阻滯劑量的影響。

設計:隨機對照研究。

單位:一家三級醫院。

患者:70名計劃接受機器人輔助腹腔鏡前列腺切除術、年齡在20~80歲之間的男性患者,ASA分級為1級或2級。

干預措施:患者隨機分為鎂組和對照組。鎂組注射鎂50mg/kg,術中連續輸注15mg/kg/h,對照組注入等量的0.9%生理鹽水。通過持續輸注羅庫溴銨維持深度神經肌肉阻滯,并用蘇加明(sugammadex)逆轉。

主要觀察指標:主要觀察指標為羅庫溴銨維持深度神經肌肉阻滯的劑量。次要結果是恢復時間,定義為從給予蘇加明到TOF的時間比值達到0.9,以及術后惡心嘔吐的發生率。

結果:鎂組維持深度神經肌肉阻滯的羅庫溴銨劑量明顯低于對照組(7.5μg/kg/min VS 9.4μg/kg/min,P=0.01)。兩組在恢復時間和惡心嘔吐發生率上無差異。

結論:鎂可使深度神經肌肉阻滯所需羅庫溴銨的劑量減少約20%,而不影響其恢復時間。

Effects of magnesium on the dose of rocuronium for deep neuromuscular blockade: A randomised controlled trial

Background: Magnesium is known to enhance the effect of rocuronium, but the extent is not quantified.

Objectives: We aimed to quantify the effect of magnesium on the dose of rocuronium for deep neuromuscular blockade.

Design: A randomised controlled study.

Setting: A single tertiary care hospital.

Patients: Seventy males scheduled to undergo robot-assisted laparoscopic prostatectomy, aged between 20 and 80 years with American Society of Anesthesiologists physical status classification 1 or 2, were enrolled.

Interventions: Patients were randomised to either the magnesium group or control group. The magnesium group were infused with 50 mg kg of magnesium, followed by a continuous intra-operative infusion at 15 mg kg h while the control group were infused with the same volumes of 0.9% saline. Deep neuromuscular blockade was maintained with a continuous infusion of rocuronium and was reversed using sugammadex.

Main outcome measures: The primary outcome was the dose of rocuronium administered to maintain deep neuromuscular blockade. The secondary outcomes were recovery time, defined as the time from the administration of sugammadex to train-of-four ratio 0.9, and the incidence of postoperative nausea and vomiting.

Results: The dose of rocuronium administered to maintain deep neuromuscular blockade was significantly lower in the magnesium group (7.5 vs. 9.4 μg kg min, P = 0.01). There was no difference in recovery time or the incidence of nausea and vomiting.

Conclusion: Magnesium reduced the dose of rocuronium required for deep neuromuscular blockade by approximately 20% without affecting the recovery time after administration of sugammadex.

Trial registration: ClinicalTrials.gov identifier: NCT04013243.

Han J, Jeon YT, Ryu JH, et al. Effects of magnesium on the dose of rocuronium for deep neuromuscular blockade: A randomised controlled trial [published online ahead of print, 2020 Sep 2]. Eur J Anaesthesiol. 2020;10.1097/EJA.0000000000001329. doi:10.1097/EJA.0000000000001329

來源:中國網醫療頻道

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