Læknablaðið - 15.01.1998, Blaðsíða 21

LÆKNABLAÐIÐ 1998; 84
19
meðalskammtur lyfs að teknu tilliti til þyngdar
sjúklings og svæfingartíma var 1,5 ug/kg á mín-
útu. Pankúrón var notað hjá 33 sjúklingum
(55%), hjá átta þeirra var pankúrón notað við
upphaf vöðvaslökunar en vekúrón notað til
viðhalds. Meðalskammtur af pankúróni var
0,8 pg/kg á mínútu. I útreikningum er miðað
við samanlagt magn vöðvaslakandi lyfja. Svæf-
ingartími var 40-290 mínútur. Tími frá síðasta
skammti vöðvaslakandi lyfs þar til mælingar
vöðvakrafts hófust á vöknunardeild var 25-130
mínútur og tími frá gjöf neóstigmíns var á bil-
inu 5^40 mínútur.
Allir sjúklingarnir fengu atrópín 1 mg og
neóstigmín 2,5 mg í lok svæfingar. Einn sjúk-
lingur fékk aukaskammt strax eftir svæfingu en
hann var enn undir áhrifum vöðvaslakandi lyfs
við komu á vöknunardeild. Enginn sjúkling-
anna fékk aukalega neóstigmín á vöknunar-
deild.
Við komu á vöknunardeild reyndust 17
□ Patients with GCS > 12 and headlift > 5 sec
■ Patients with GCS > 12 and headlift < 5 sec
Measurment on arrival Measurment after 30 min Measurment after 60 min
Fig. 1. Postoperative restcurarization in the Postanesthesia
CareUnit. Thefigure shows three groups ofpatients. Thegrey
bar shows those that have recovered with headlift >5 sec and
GSC (Glasgow coma score) >12. The black bar shows those
patients believed to be restcurarized, with headlift <5 sec and
the white bar shows patients that are unable to co-operate,
with GCS <12. All patients had recovered after 90 minutes.
Table I. Demographic data. Patients with Glasgow coma score (GCS) >12 are divided into two groups; those with headlift more than 5 sec and those with headlift under 5 sec, the latter believed to be restcurarized. The data shows that there is no statistical difference between the groups on arrival but there is difference after 30 min in age and gender.
Patients with GCS >12
Measurement on arrival in PACU Measurement 30 minutes after arrival
Mean all Headlift Headlift Headlift Headlift
patients >5 sec <5 sec P-value >5 sec <5 sec P-value
Number of patients 60 43 10 54 6
Age (years) 47 46 52 ns 45 62 0.0007
Males/females 21/39 16/27 2/8 ns 21/33 0/6 0.0002
Bodyweight (kg) 75.9 75.8 75.6 ns 76.3 72.8 ns
Hemoglobin (g/L) 137 135 141 ns 136 143 ns
PACU = Postanesthesia Care Unit
ns = non significant
Table II. Muscle relaxation and reversal. The tableshows valuesfor time and dose ofeach muscle relaxant. For those thatsustain
headlift 5 sek and those that do not, there is no statistical difference in which drug is used, dose of drug or time from last dose
except for pancuronium were time is relatively shorter.
Measurement on arrival in PACU. Patients with GCS >12
Headlift Headlift
Unit Mean > 5 sec <5 sec P-value
Duration of anesthesia min 96.0 95.5 92.5 ns
Time from last dose min 66.4 68.0 62.5 ns
Time from neostigmin min 17.0 16.3 17.5 ns
Vecuronium number 27.0 19.0 5.0
Time from last dose min 60 57.9 66 ns
Mean dose mg 8.0 8.5 6.4 0.008
Mean dosage/kg mg/kg 0.11 0.12 0.10 ns
Dose/kg/time ug/kg/min 1.54 1.50 1.90 ns
Pancuronium number 33.0 24.0 5.0
Time from last dose min 71.7 76 59 0.02
Mean dose mg 5.6 5.5 5.4 ns
Mean dosage/kg mg/kg 0.07 0.07 0.06 ns
Dose/kg/time irg/kg/min 0.77 0.78 0.69 ns
PACU = Postanesthesia Care Unit
ns = non significant