Comparison Of Clinical Effects Between Target-Controlled Infusion And Continuous Vecuronium

In the recent years,vecuronium has been used in clinical anesthesia more widely than before and the methods it can be used in and its clinical effects have got much attention from anesthetists.Vecuronium has many merits such as stable effects,no histamine released,can be removed quickly in plasma ,etc.While except for other anesthetics,antibiotics and over ventilation can influence the effects of vecuronium,but the methods used in anesthesia may have something with its clinical effects,too.In this observation,we try to compare the clinical effects of vecuronium administered by Target-controlled infusion and continuous infusion and expect to get a more reasonable way in the clinical use of neuromuscular blockade. Forty ASA I-II patients,scheduled for elective epigastrium surgery under general anesthesia were enrolled in the study,and their ages were between 28⁶6 years,their weights were limit to 20% fluctuation of their normal weights.They had normal function of heart ,lung,liver,kidney and hadn't neuromuscular diseases.And the patients were randomly allocated into two groups(20 in each group) according to the different administration of vecuronium,groupT(vecuronium was infused by TCI) and group B (vecuronium was infused continuously).The patients were premedicated with intramuscular scopolamine 0.3 mg.In this observation,we monitored ECG,HR ,BP and SpO2 continuously,and at the same time we monitored BIS and neuromuscular block (NMB),and the NME was assessed by electromyography and the desired degree of NMB was 25%(T1/Tc=25%).Anesthesia was induced with midazolam 0.01 mg/kg ,Fentanyl 2³Î¼g/kg , propofol was infused by TCI at the target concentration of 3μg/ml. In group T, vecuronium was used for muscle relaxation by TCI at the target concentration of 0.5μg/ml ,tracheal intubation was facilitated when T1/Tc was 5% and aftertracheal intubation vecuronium was administered at the target concentration of 0.15⁰.2μg/ml to maintain T1/Tc at 25%.In group B, tracheal intubation was facilitated with vecuronium 0.1mg/kg ,then vecuronium was administered continuously at the speed of 2μg/kg.min to maitain T1/Tc at 25% .Anesthesia was maintained with propofol administered by TCI and intermittent iv boluses of fentanyl 0.05⁰.1mg.We stopped infusing vecuronium when the surgeons began to close the peritoneum.After 20 minutes of operation,neostigmine 0.01mg/kg would be given if the patients couldn't keep their SPO₂ at 94% or more when oxygen was not given.Memorised the followings(1)the value of ECG,HR,BP,SPO2 .(2)BIS of these patients in operation.(3)the consumption of propofol,midazolam, fentanyl and vecuronium,and the cases need to be given neostigmine.(4) the recovery times of breath and the tracheal extubation times of these patients.The results were expressed with"Χ±S",statistic analysis was performed with T test to examine intergroup differences.The p<0.05 was considered statistically significant. Results All the patients in these groups had no difference in basic information. The incidence of postoperative residual neuromuscular blockade was greater in group B(7 cases) than that in group T(1 case).And the recovery times of breath in group B were (22.7±8.3)min and (16.7±8.2)min in group T,the difference was significant (p<0.05).The tracheal extubation times in group B were (21.0±7.2)min and (9.2±2.0) in group T and there was significantly diffenrence statistically(p<0.05).The consumption of propofol, midazolam,fentanyl and vecuronium had no significant difference in both group B and group T(P>0.05).And at the same time in operation,BIS of these two groups had no significant difference. Conclusion TCI has been one of the most important development in clinical anesthesia,and according to different targets,TCI can be divided into target plasma and target effectcomparment.We chose target effectcomparment to infuse vecuronium in this observation.