目的 观察帕金森病(Parkinson's disease,PD)与非PD患者罗库溴铵的神经肌肉阻滞效应.方法 纳入年龄 18～65岁,美国麻醉医师协会(American Society of Anesthesiologists,ASA)Ⅰ～Ⅲ,接受丘脑底核-脑深部电刺激手术的PD患者(PD组)31 例和行面神经减压的非PD患者(non-PD组)24 例为研究对象.麻醉诱导单次给予罗库溴铵(0.6 mg/kg),采用四个成串刺激(train-of-four,TOF)监测肌松,记录罗库溴铵体内作用时间(the duration of 90%recovery of TOF,DURTOF 90%)、起效时间、临床作用时间、恢复指数和术毕 2 h内严重呼吸系统并发症发生情况.结果 与non-PD组比较,PD组DURTOF 90%和临床作用时间均显著延长,差异有统计学意义(P<0.05);2 组患者的起效时间差异无统计学意义(P>0.05).PD患者的罗库溴铵DURTOF 90%与病程相关,病程越长,DURTOF 90%越长.2 组患者术后均无严重呼吸系统并发症发生.结论 PD患者应用罗库溴铵的DURTOF 90%和临床作用时间明显延长,且DURTOF 90%与病程呈正相关.
Neuromuscular blocking effects of rocuronium in patients with Parkinson's disease
Objective To observe the neuromuscular blocking effects of rocuronium in patients with Parkinson's disease(PD)compared to non-PD patients.Methods This study included 31 American Society of Anesthesiologists(ASA)Ⅰ-Ⅲ PD patients(PD group)aged 18-65 years undergoing subthalamic nucleus-deep brain stimulation(STN-DBS)surgery and 24 non-PD patients(non-PD group)undergoing facial nerve decompression.Anesthesia was induced with a bolus of rocuronium(0.6 mg/kg)intravenously,and neuromuscular block was monitored with train-of-four(TOF).The duration of 90%recovery of TOF(DURTOF 90%),onset time,clinical duration,recovery index,and occurrence of severe respiratory complications within 2 hours after surgery were recorded.Results Compared to the non-PD group,both DURTOF 90%and clinical duration were significantly prolonged in the PD group(P<0.05).There was no significant difference in the onset time of rocuronium between the two groups(P>0.05).In PD patients,the DURTOF 90%of rocuronium was positively correlated with the course of the disease,with a longer course associated with delayed DURTOF 90%(P<0.05).There were no severe respiratory complications in both groups after surgery.Conclusions The DURTOF 90%and clinical duration of rocuronium are significantly prolonged in patients with PD,and the DURTOF 90%is positively correlated with the course of the disease.
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