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Læknablaðið - 15.01.1998, Qupperneq 21

Læknablaðið - 15.01.1998, Qupperneq 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
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