The Effect of the Residual Neuromuscular Blockade Caused by the Different Dose of Cisatracurium

Objective To observe the effect of the residual neuromuscular blockade caused by the different dose of cisatracurium.Methods 80 ASAⅠorⅡpatients aged from 18 to 70,undergoing selective spinal surgery with general anesthesia,were equally randomized into four groups( n = 20).In group A1,patients received cisatracurium by continuous infusion with 0.75 μg·kg-1·min-1and 1.5 μg· kg-1·min-1in group A2,group B1 by intermittent bolus injection with 0.05 mg·( kg·h)-11and group B2 with 0.1 mg·( kg· h)-1as well.After the induction,design the total dose of group A1 and B1 are the same,both of group A2 and B2,responses of adductor pollicis muscle to train-of-four( TOF) stimulation were monitored.Stop all the drugs 20 minutes before the end of the surgery and recorded the cisatracurium consumption and TOF recovered to 25%,50%,75%,90%,extubation time,continue to look up 5 s,tidal volume and respiratory rate both before and after anesthesia.Results SBP,DBP,breathing rate and oxygen saturation at extubation in four groups of patients showed no statistically significant difference compared with those at preoperative( P 0.05).The heart rate was significantly faster in four groups of patients and tidal volume tube drawing in three groups( A2,B1,B2) of patients at extubation was significantly higher than those at preoperative( P 0.05).In the same ways of giving cisatracurium,patients in the high-dosage groups got a longer time of TOFr recovery to 25%,50%,75% and 90%,respectively( P 0.05) than patients in the low dose group did( P 0.05),and the same results as the clinical indications of monitoring muscle relaxant residual effect,muscle force back to Ⅳ-Ⅴ level,continue to look up 5s,while there was no statistical significant difference comparison in extubation time and the eyes opening time( P 0.05).And at the same doses,patients in the continuous infusion group got a longer time of TOFr recovery to 25%,50% and 75%,respectively( P 0.05) compared with patients in the intermittent bolus injection group.The time of TOFr recovery to 90% and the clinical indications of monitoring muscle relaxant residual effect,( extubation time,continue to look up 5 s,etc.) had no obvious difference( P 0.05) between two groups.Conclusion The dose of cisatracurium has influence on the residual effect of muscle relaxant.High dose may prolong the muscle recovery time.