Comparison Of The Neuromuscular Blockade Of Cisatracurium After Prolonged Infusion During Propofol Target Controlled Infusion And Sevoflurane Anesthesia

Objective To compare the neuromuscular blockade of cisatracurium after prolonged infusion during propofol target controlled infusion and sevoflurane anesthesia.Methods Twenty ASA I or II,18-65 years old adults undergoing elective oral-maxillofacial carcinoma surgery, surgical procedures of relatively long duration(4h), were allocated randomly to either propofol+remifentanil anesthesia (group P, n=10) or sevoflurane+ remifentanil anesthesia (group S, n=10) . Operation, in accordance with blood pressure and heart rate to adjust parameters such as remifentanil and propofol, sevoflurane infusion rate, etc. P group maintained at the target propofol effect-solubility in 3μg.ml-1 above, the concentration of sevoflurane inhalation maintained at more than 1.0MAC. Neuromuscular block was monitored using train-of-four stimulation by a muscle relaxation monitor(TOF Watch SX). Cisatracurium was administered in an initial bolus dose of 0.2mg.kg-1 followed by an infusion adjusted mannally to maintain the T1 ,the first response in the train-of-four,at 10% of control. Following cessation of rocuronium infusion all the patients were allowed to recover spontaneously. The follow variables were recorded:the infusion rate,parameters such as total amount of all hours, T1 recovery from 10% to TOF ratio of 70% of the time. After the second day, according to the method proposed by Brice and Moerman follow-up, to determine whether there has been intraoperative awarenessResults At the first second third fourth hour,the infusion rates were 2.28±0.19,1.97±0.18,1.91±0.16,1.90±0.12μg.kg-1.min-1 and 2.00±0.19,1.44±0.18,1.38±0.23,1.38±0.23μg.kg-1.min-1(P<0.05)for the groups receiving propofol and sevoflurane anesthesia. At the first,second,third,fourth hour, respectively cumulative amount were 163.3±11.0,130.2±12.3,115.9±10.5,114.4±10.0μg.kg-1和161.3±9.9,108.3±10.9,84.6±11.8,82.2±13.6μg.kg-1 for the groups receiving propofol and sevoflurane anesthesia.Conclusion The final infusion requirement to maintain the T1 at 10% of control was reduced by 27.4% during sevoflurane anesthesia than propofol anesthesia.And The fourth consumption was decreased by 27.6% cumulative, during sevoflurane anesthesia than propofol anesthesia。Under two different anesthetic methods, 4h after the cis-atracurium, T1 recovery from 10% to TOF ratio of 70% of the time no significant difference.