米库氯铵用于老年患者的肌松残余作用研究.

Objective: To observe the advantage of recovery of neuromuscular blockade of Mivacurium continuous venous infusion in the aged patients undergoing general anesthesia during extubation and investigate the relationship between the recovery and the plasma cholinesterase. Methods: 48 female patients scheduled for gastroenteric tumor resection under laparoscopic surgery were randomized into two groups(n=24 each group). The patients in group C were given Cisatracurium Besilate continuous infusion and the patients in group M were administered with Mivacurium continuous infusion. The contract reaction of adductor pollicis was monitored through train-of-four ratio(TOFR) by stimulating ulnar nerve. The MAP, HR, BIS, condition of recovery from neuromuscular blockade,untoward effect after operation, the activity of the plasma cholinesterase was recorded at the time of induction of anaesthesia and extubation. Results: There was no difference in the age, height, weight, operation time, hemorrhage, temperature, fluid infusion volume.Group M was lower than group C obviously at the recovery of TOFR to 25%, recovery index time, to 70%, 70% to 90%, the time from stopping infusion to extubation. To a certain extent, the activity of the plasma cholinesterase(D1 and D2)appeared to be negatively related to the time of the recovery of TOFR to 25 %, recovery index time, to 70 %, 70 % to 90 % and the time from stopping infusion to extubation, but it was not statistically significant(P>0.05). The incidence of postoperative residual curarization was lower in group M(P<0.05). Conclusions: In the aged patients undergoing general anesthesia during extubation, the recovery from neuromuscular blockade by continuous infusing Mivacurium is fast and the postoperative residual curarization is less, which is related to the activity of the plasma cholinesterase. [ABSTRACT FROM AUTHOR]