Eur J Anaesthesiol:地塞米松能缩短全麻患者罗库溴铵神经肌肉阻滞的持续时间:随机对照研究

2014-07-14 MedSci MedSci原创

Title:Dexamethasone decreases the duration of rocuronium-induced neuromuscular block: A randomised controlled study.Authors:Ledowski T1, Falke L, Johnston F, Gillies E, Greenaway M, De Mel A, Tiong WS

背景:多种药物可影响全身麻醉中神经肌肉阻滞的时间进程。

目的:评价单次静脉注射地塞米松(8毫克)对罗库溴铵神经肌肉阻滞时间的影响。

设计:随机、非盲法、单中心研究。

患者:108位接受妇科腹腔镜手术成年患者,随机分配到三个组。

干预方法:A 组:患者术前2-3h静脉注射地塞米松8毫克,B 组:手术前诱导麻醉注射相同剂量地塞米松,C 组(对照组):在恢复神经肌肉阻滞期间后注射相同剂量地塞米松。

主要观察指标:给予0.3 mg/kg剂量罗库溴铵后使用肌肉加速度描记法来评价神经肌肉阻滞的时间,主要观察终点是从注射罗库溴铵直到TOF值达到 0.9的时间长短。

结果:

与 B 组相比较 (18.7±5.8分钟;P=0.031),A 组 (15.8±4.5分钟)神经肌肉阻滞持续时间较短。与 B 组比较 (8.1±2.6分钟;P=0.018) 和 C 组 (8.3±2.8 分钟;P=0.01)相比较, A 组恢复指数 (6.8±1.8 分钟) 缩短; 。与 B 组 (36.3±10.7 分钟 ;P=0.031) 和 C (36.8±11.3min;P=0.02)相比较,TOF值达到 0.9 所需时间A 组 (30.4±6.9min)最短。

结论:麻醉诱导前 2 - 3 h单次静脉注射8mg地塞米松能缩短罗库溴铵引起的神经肌肉阻滞的持续时间15%-20%,但麻醉诱导过程中使用地塞米松不影响神经肌肉阻滞的时间。


MedSci翻译,由会员周磊校正。


英文原文阅读:

Title:Dexamethasone decreases the duration of rocuronium-induced neuromuscular block: A randomised controlled study.

Authors:Ledowski T1, Falke L, Johnston F, Gillies E, Greenaway M, De Mel A, Tiong WS, Phillips M.

BACKGROUND

Several drugs influence the time course of neuromuscular block during general anaesthesia.

OBJECTIVE

To evaluate the effect of a single dose of dexamethasone 8 mg on the time course of a rocuronium-induced neuromuscular block.

DESIGN

A randomised controlled, unblinded, monocentre trial.

SETTING

Kreiskrankenhaus Dormagen, Dormagen, Germany.

PATIENTS

One hundred and eight adult patients scheduled for elective gynaecological laparoscopic surgery allocated to three groups.

INTERVENTIONS

Patients received dexamethasone 8 mg intravenously 2 to 3 h prior to surgery (Group A), during induction of anaesthesia (Group B) or after recovery of the neuromuscular block (Group C, control).

MAIN OUTCOME MEASURES

The time course of the neuromuscular block of rocuronium 0.3 mg kg was assessed using acceleromyography. The primary end point was the time from start of injection of rocuronium until recovery to a train-of-four ratio of 0.9.

RESULTS

The clinical duration was decreased in Group A (15.8 ± 4.5 min) compared with Group B (18.7 ± 5.8 min; P = 0.031). The recovery index was reduced in Group A (6.8 ± 1.8 min) compared with Group B (8.1 ± 2.6 min; P = 0.018) and Group C (8.3 ± 2.8 min; P = 0.01). The recovery to a train-of-four ratio of 0.9 was shorter in Group A (30.4 ± 6.9 min) than in Groups B (36.3 ± 10.7 min; P = 0.031) and C (36.8 ± 11.3 min; P = 0.02).

CONCLUSION

A single dose of dexamethasone 8 mg attenuated rocuronium-induced block by 15 to 20% if administered 2 to 3 h prior to induction of anaesthesia. However, the administration of dexamethasone during induction of anaesthesia did not influence the time course of the neuromuscular block.

MedSci翻译中

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    2015-12-26 hixiaoluo

    值得收藏,学习,谢谢分享

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    2015-01-10 AspirantSuo
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    2015-03-24 xiangyuzhou971
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    2014-10-20 amyloid
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    2014-07-16 zhwj
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    2014-07-16 skhzy

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对于郁积型多发性骨髓瘤患者,标准治疗是观察直至出现症状。但是,这种方法不能甄别可从早期干预中获益的高危患者。西班牙萨拉曼卡大学医院血液学San Miguel博士对这一领域进行了深入研究,他们发现,对高危郁积型骨髓瘤早期治疗可延缓疾病进展至活动性,并提高总生存率。相关论文发表于国际权威杂志NEJM 2013年8月在线版。 在该项随机、开放标签、三期试验中,研究者将119

CDD:地塞米松诱导骨质疏松可能与Wnt/beta-catenin信号通路有关

  近日,国际生物医学学术期刊Cell Death and Disease在线发表了中科院上海生命科学研究院健康科学研究所戴尅戎研究组题为Dexamethasone shifts bone marrow stromal cells from osteoblasts to adipocytes by