Effects Of The Residual Neuromuscular Blockade Caused By The Different Administration And Dose Of Cisatracurium

Objective To observe the effects of the residual neuromuscular blockade caused by thedifferent administration (continuous infusion and intermittent bolus injection) and different doseof cisatracurium.Methods Eighty ASA?or?patients, aged from18to70,undergoing selective spinalsurgery with general anesthesia, were equally randomized into four groups (n=20). In group A1,patients received cisatracurium by continuous infusion with1.5?g·kg-1·min-1and0.75?g·kg-1·min-1in group A2, group B1by intermittent bolus injection with0.1mg·kg-1·h-1andgroup B2with0.05mg·kg-1·h-1as well. After the induction, design the total dose of group A1andB1are the same, both of group A2and B2, responses of adductor pollicis muscle to train-of-four(TOF) stimulation were monitored. Stop all the drugs20minutes before the end of the surgeryand recorded the cisatracurium consumption and TOF recovered to25%,50%,75%,90%,extubation time, continue to look up5s, tidal volume and respiratory rate both before and afteranesthesia.Results (1) It has no statistically significant difference were observed for the four groupsof patients upon the age, gender, weight, and the preoperative vital signs (P>0.05).(2) It has nostatistically significant difference for the four groups upon the tide volume, respiratory frequency,and oxygen saturation before the operation; Compared with the preoperative conditions, thestatistically significant difference on the respiratory frequency (RP) an oxygen saturation can't beobserved when drawing the tube (post operation). However, the tide volume (Vt) increased forthe groups of A1, B1, and B2compared with previous.(3) Time comparison for the four groupsas the TOFr values reach to25%,50%,75%and90%. For A1and B1, A1shows a longer timefor the TOFr recover to25%, then it has no statistical significance for the time of the TOFrrecover to50%,75%and90%(P=0.05). For A2and B2, it is longer for the TOFr value of group A2to recover to50%and75%, then the25%and90%time show no statistical significance(P=0.05). For A1and A2, the TOFr time for25%and50%are longer than A2, it is no statisticallysignificant difference as the TOFr recover to75%and90%for groups A1and A2(P=0.05). ForB1and B2, the longer time for B1as the TOFr recover to50%,75%and90%, in addition, theTOFr for25%has no statistically significant difference.(4) The comparison of the clinicalindications for the four groups of patients with muscle relaxant recovery. For A1and B1, it has nostatistical significance (P=0.05) for the time of extubation, first open, muscle strength back tolevel ?-?and looked up to5s, further for the total dose of cisatracurium. The comparison forA2and B2shows the same results as the comparison of A1and B1. For A1and A2, it is longerfor the A1patients to look up for5s and the muscle recovery to level ?-? is also longer thanA2(P<0.05). Then the extubation time and first open time are in no statistical significance(P>0.05). For B1and B2, B1shows a larger total dosage of cisatracurium compared with B2(P<0.05).(5) There is no statistically difference for all the four groups upon the total operationtime, anesthesia time, intraoperative rehydration and the urine volume (P>0.05).Conclusion The different ways of drug delivery of cisatracurium has no obvious influenceon residual muscle relaxant effect, but continuous infusion can prolong muscle relaxant recoverytime. High doses also can prolong the time for muscle function for patient to recovery.