层流手术室课件.ppt

1、1234 5 6 78 9 10TOF Ratio0,40,50,60,70,80,91,0Per centof control20406080100FEV1FIV111121314151617 18Berg,Viby-Mogensen Acta Anaesth Scand 1997;41:1095-110319 罗库溴铵诱导剂量后，待T1恢复到10%开始罗库溴铵的靶控输注 血浆靶浓度为2g/ml，维持肌松T1%10%手术结束前10min停止输注罗库溴铵202122232425食道括约肌张力与TOFr的相关比较Eriksson LI et al Anesthesiology 1997;87:1

2、035-1043050100150ControlTOF 0.6TOF 0.7TOF 0.8TOF 0.9*26TOF-ratio吞咽困难baseline6%0.628%*0.717%*0.820%*0.913%*p0.05 vs.baseline27小 结28 29 3031 3233343536Sundman et al Anesthesiology 2000;92:97737 38 394070 60 50 40 30 20 10 0 120min n=23 n=101 n=164 n=23841v在单次注入中效肌松药并不进行拮抗的情况下，即使在2小时以上，发生残余神经肌肉阻滞仍较普遍。v客观测定神经肌肉传递功能是诊断残余神经肌肉阻滞的较可靠方法。4243 44 4546474849拮 抗50Kopman AF,Antagonism of cisatracurium and ocuronium block at a tactile train-of-four count of 2:should quantitative assessment of neuromuscular function be mandatory?Anesth Analg.2004；98(1):102 51拮抗的缺点 525354555657 谢 谢58