Comparison pharmacodynamics of continuous or intermittent cisatracurium infusion during laparoscopy for deep neuromuscular blockade / 临床麻醉学杂志

ABSTRACT

Objective To investigate continuous infusion and inermittent injection of cisatra-curium for deep neuromuscular blockade during laparoscopic surgery and to compare the effectiveness and safety.Methods Sixty ASA Ⅰ or Ⅱ patients,aged from 18 to 65,undergoing selective laparo-scopic gastrointestinal surgery with general anesthesia were randomly divided into 2 groupsgroup A (n =30)received cisatracurium 0.1 5 mg/kg for intubation,and then continuous infusion of cisatra-curium with micropump at an original rate of 0.2 mg·kg-1 ·h-1 when post tetanic count (PTC)≥3;group B(n =30)was given cisatracurium 0.1 5 mg/kg for intubation,and then intermittent infusion of cisatracurium of 0.05 mg/kg when PTC≥ 3.The cisatracurium consumption,duration of neuro-muscular blocking agent used in group A from induction to the end of infusion and in group B from in-duction to the last infusion,satisfaction of neuromuscular blockade (grade 0-10)of the surgeons,the time of T1 recovered to 25%,75%,TOFr recovered to 0.7,0.9,fulfillment of tongue depressor test,the incidence of hyoxemia after extubation,pneumonia,atelectasis were recorded.Results In comparison with group B,the cisatracurium consumption in group A was significantly more (P <0.05),and the satisfaction of the surgeons was significantly higher at the beginning,1 h,2 h of the operation (P <0.05).The satisfaction of the surgeons respectively showing no significant differences between the two groups at the end of the operation.Recovery index (T1 from 25% to 75%),time of TOFr recovery to 0.7,0.9 in group A was increased,but not statistically.Two patients (7.1%)in group A had hyoxemia after extubation while 1 (4.2%)in group B,the incidence rate was not signifi-cant;3 patients (10.7%)in group A was unable to perform sustained tongue depressor test while 4 (1 6.7%)in group B,the incidence was not significant;all of the patients did not suffer pneumonia and atelectasis.Conclusion Continuous infusion cisatracurium during laparoscopic procedures for deep neuromuscular blockade is effective and safe.The dose of cisatracurium is bigger,and muscular relax-ation would be deeper compared to intermittent infusion.Continuous infusion may prolong the working time of muscle relaxant,but have on influence on the residual effect of muscle relaxant.