Clinical Research Of The Cis-atracurium Applied Aged Patients In Three Ventilation Modes

Objective:By the changes of three different ventilation modes,to observing the neuromuscular blockade effect of two kinds muscle relaxants applied aged patients, advising aged patients how to rational use muscle relaxants, specifically aged patients who have the diseases about hyperventilation or hypoventilation.Or the aged patients who need hyperventilation or hypoventilation in surgery.Methods:Select the 60 aged patients with cholecystectomy were randomly divided into Group A(Cis-atracurium group) and Group B(Vecuronium group), with 30 patients each.After anesthesia was induced, ventilation with Mask,the groups of Group A and Group B randomly divided into three groups, including:1. hyperventilation group(PETCO2 about 25mmHg),2. hypoventilation group(PETCO2 about 60 mm Hg),3. normoventilation group(PETCO2 about 35-40mmHg). Mechanical ventilation according to the above PETCO2 parameters after endotracheal intubation. Keeping the above PETCO2 parameters while monitoring. Stimulation of the ulnar nerve by TOF. After steady, the time of the neuromuscular blocking effects were monitored for determination of onset time, duration of maximum effect, recovery intervals 25%一 75% and Blood gas analysis intervals 0-25% of T1,with Group A(after induced with cis-atracurium 0.1mg/kg)and Group B(after induced with vecuronium 0.1mg/kg).Experimental data analysis applications SPSS17.0 statistical analysis software, count variance was used to compare the group,Between groups were analyzed using t-test grouping, count data were compared with the2? test, hypothesis testing position α=0.05 level,P<0.05 was considered statistically significant.Results: Group A, A1 of muscle relaxation time to reach the maximum difference between the A 3 had no significant. The A2 were significantly shorter than the A1, A3(P<0.05). A1 of muscle relaxants maximum duration of action and recovery index group were significantly shorter than A2, A3(P<0.05). Group B, B1,B2,B3 to achieve maximum muscle relaxation time, the duration of maximum action, and recovery index all no significant difference.Three groups of patients in Group A, TOF’s T1 recovered to 25% of blood gas analysis results can be seen, A1 of arterial blood p H values were higher than the A3, PaCO2, HCO3- were lower than the A3, And contrary to the case of A2, Arterial pH values were lower than A3(P<0.01), PaCO2, HCO3- were higher than A3(P<0.05 或P<0.01).Three groups of patients in control group arterial p H, PaCO2, HCO3-situation no significant difference with Group A(P >0.05).The time of muscle relaxation to reach the maximum is significantly shorter thatthree groups of patients in group B than the three groups of patients in group A, but it is significantly longer of the maximum duration of action of muscle relaxants.Conclusion: During the hyperventilation, the duration of action are lengthened with nochange in the onset time of cisatracurium.However,during the hypoventilation,the onset time of cisatracurium shortened with no change in the duration of action. But ventilation changes had no significant effect on vecuronium.