The Muscle Relaxation Of Cisatracurium In Gynecological Laparoscopic Surgery Fast Track Anesthesthesia

Objective To compare the muscle relaxation characteristics of a single intubating does of cisatracurium and vecuronium in gynecological laparoscopic surgery fast track anesthesthesia,and investigate the application worth of cisatracurium in this surgery.Methods After written the informed consent.100ASA Ⅰ～Ⅱ grade patients scheduled for elective gynecological laparoscopic surgery were allocated into two groups:group A cisatracurium(0.15mg/kg)and group B vecuronium (0.12mg/kg) randomly,50patients in each group.The muscle relaxation was recorded with the TOF-Watch(?)SX(Organon),stimulation pulse width at200μs,stimulation at15s intervals with submaximal current50mA.Both groups of induction and maintenance anesthesia with propofol-remifentanil by TCI.The HR and MAP were recorded in every period time during the anesthesia,such as preanesthesia(TO)、after induction(T1)、endotracheal intubation(T2) and1、3、5min after intubation (T3、T4、T5).The patients’ condition of tracheal intubation were evaluated.The onset time、no-response time、clinical duration、T175%recover time、recovery index and PORC were recorded at PACU.The SpO2were recorded in every period time during the suturing time (T6)、consciousness time(T7)、extubation time (T8) and outing the operationroom (T9).And the consciousness time、respiratory recovery time、extubation time and stay PACU time were observed.During the surgery the performance of histamine release was observed.At the second day,according to the Brice and Moerman’s proposed,all the patients were followed up to determine whether awareness or not.The values were reported as Mean±SD.All the datas were analyzed using analysis of between groups for t-tests and χ2tests for categorical data (SPSS software version13.0).A value of P<0.05was considered statistically significant.Results(1)There were no statistically significant among the two groups in age、 BMI、haemoglobin,et al(P>0.05).(2)There were no statistically significant in MAP and HR at preanesthesia(TO)、after induction(T1)、endotracheal intubation(T2) and1、3、5min after intubation(T3、T4、T5)(P>0.05).(3)A11patients had good condition of tracheal intubation with no statistically significant (P>0.05).(4)And there was statistical differences of the onset time between group A and group B(P<0.05).Significant differences were observed in the no-response time、clinical duration、T175%recover time and recovery index of two groups(P<0.01).(5)But the PORC were significant differences among the two groups at PACU:group A4%,group B22%(P<0.01);and the PORC time:group A2.73±0.87min,group B10.43±1.90min(P<0.01).(6)There were statistical difference in SpO2at the consciousness time(T7)、extubation time (T8) and outing the operationroom (T9)(P<0.05).(7)The consciousness time was no statistically significant among the two groups(P>0.05).But the group A were shorter in group B in the spontaneous respiratory time、extubation time and stay PACU time (P<0.01).(8)A11the patients were not histamine release,no hypoxemia and no awareness.Conclusion A single intubating does of cisatracurium had some advantage to vecuronium in gynecological laparoscopic surgery fast track anesthesthesia.Cisatracurium had low PORC at PACU to further explandation.