Comparison Of The Residual Neuromuscular Block Caused By Different Administration Ways Of Vecuronium

Objective:To compare different administration ways of vecuronium and to observe onset time,intubation scores,the average amount of vecuronium,several indices of muscle relaxant recovery,satisfactory scores of muscle relaxant,the number of events caused by adversed muscle relaxants,recovery of myodynamia and so on.The purpose is to explore the difference of muscle relaxant recovery between different administration ways of vecuronium,and to look for the reasonable administration ways and suitable muscle relaxant depth of laparotomy which provide references for clinical administration.Method:Choosing 80 patients with endotracheal intubation general anesthesia laparotomy who were scheduled for gastric or colorectal cancer surgery,aged 40-70 years,ASA grade?/?,BMI(body mass index,BMI):(18 ~ 25)kg·m-2 by total intravenous anesthesia and operation time is longer than 90 min.They were randomly divided into four groups with 20 cases in each group.The four groups are increasing drug condition T1 = 10% closed loop infusion of muscle relaxant injection system(C1 group),increasing drug condition T1 = 20% closed loop infusion of muscle relaxant injection system(C2 group),increasing drug condition T1 = 10% intermittent bolus infusion(I1 group),and increasing drug condition T1 = 20% intermittent bolus infusion(I2 group)respectively.Recorded data: T1 calibration current,onset time, intubation scores,the total amount of muscle relaxant drugs,muscle relaxants infusion time,operation starting and ending time,T1 = 25%,75%,90%,TOF = 25%,75 %,90%,extubation time,continuing the rise time 5s,muscle relaxants satisfaction,muscle relaxants adverse events,extubation(M0),5min(M1),10min(M2),15min(M3),20min(M4)strength rating.Calculated data: the average amount of muscle relaxant D,recovery time t1(T1 recover from 25% to 75%),t2(T1 recover from 25% to 90%),t3(TOFr recover from 25% to 75%),t4(TOFr recover from 25% to 90%),t5(withdrawal to extubation),t6(end of surgery to extubation),t7(extubation to rise for five seconds).Results:(1)There was no significant score differences(P > 0.05)among proportion of four groups of sex,age,body mass index(BMI),T1 calibration current,onset time,operation time and intubation scores.(2)Compared with group C1,the D and t4 of group C2,the D,t4,t6 of group I1,and the D,t3,t4,t5,t6 of group I2 were obviously decreased,and the difference was statistically significant(P< 0.05);Compared with group C2,the D,t3,t4,t5,t6 of group I2 was significantly decreased(P< 0.05);Compared with group I1,group I2 show significant difference in D and t4(P< 0.05).(3)Compared with group C1 and C2,there was statistically significant differences of group I1 and I2 in satisfactory scores of muscle relaxant,but show no difference between group C1 and C2,as well as group I1 and I2.(4)Compared with group C1,myodynamia show significant differences in group I1 and I2 extubation immediately(M0),but no statistically significant differences between other groups;Each two groups have no significant difference at 5min(M1)and 10 min(M2);Compared with the group C1 and C2,more quickly muscle recovery showed in group I2 at 15min(M3)(P <0.05);Compared with group C1,the remaining three groups got rapid muscle recovery at 20min(M4)(P <0.05),muscle recovery much quicker in group I2 than in the group C2 and I2(P <0.05).Conclusion:Compared with closed loop infusion,vecuronium intermittent bolus injection with neuromuscular monitoring could provide rapid neuromuscular recovery.Maintaining T1 between 0 and 20% by vecuronium intermittent bolus injection with neuromuscular monitoring can meet the needs of open surgery.