长期糖皮质激素用药对老年全麻手术患者罗库溴铵肌松效应的影响

Effects of long-term glucocorticoid administration on neuromuscular block of rocuronium bromide in elderly patients undergoing operation

摘要:

目的 探讨长期糖皮质激素用药对老年全麻手术患者罗库溴铵肌松效应的影响。方法 入选2013年1月至2015年12月在中山市中医院行全麻胆囊切除术的老年患者60例，根据患者连续使用糖皮质激素（布地奈德）是否≥3个月分为两组：激素组和非激素组，每组30例。术中静脉注射罗库溴铵0.6 mg/kg，采用TOF-Watch SX加速度仪监测肌松程度，记录罗库溴铵起效时间、肌纤维颤搐最大抑制程度、临床作用时间、恢复指数。结果 与非激素组相比，激素组患者使用罗库溴铵后的起效时间显著延长，而肌纤维颤搐最大抑制程度、临床作用时间和恢复指数则显著减少，差异均具有统计学意义（P<0.05）。结论 长期糖皮质激素用药可减弱老年患者全麻手术中罗库溴铵的肌松效应。

Abstract:

Objective To determine the effect of long-term treatment of glucocorticoid on neuromuscular block of rocuronium bromide in the elderly patients undergoing operation. Methods Sixty elderly patients who were scheduled for elective cholecystectomy under general anesthesia in our hospital from January 2013 to December 2015 were enrolled in this study. According to taking glucocorticoid treatment (budesonide) for over 3 months or not, the patients were divided into glucocorticoid group (n=30) and non-glucocorticoid group (n=30). During the operation, 0.6 mg/kg rocuronium bromide was infused intravenously, and accelerography (TOF-WATCH SX) was used to measure muscle relaxation. The onset time, degree of maximum neuromuscular block, clinical action duration and recovery indices were recorded and compared between the groups. Results Compared with the non-glucocorticoid group, the onset time was significantly longer, while the degree of maximum neuromuscular block, clinical action duration and recovery indices were obviously reduced in the glucocorticoid group (P<005). Conclusion Long-term administration of glucocorticoid reduces neuromuscular block of rocuronium bromide in the elderly patients undergoing operation.