目的 观察全身热疗（whole body hyperthhermia，WBH）对晚期癌症患者全凭静脉麻醉（total intravenous anesthesia，TIVA）中阿曲库铵（atracurium）用量和作用时间的影响。方法 晚期癌症TIVA患者，分非高温组，高温组。监测两组患者的体温、心电图、中心静脉压、脉搏氧饱和度、PH值，呼末二氧化碳分压等；记录各组阿曲库铵用量。监测停止输注阿曲库铵时、4个成串刺激（train of four，TOF）从 10%恢复至25%、50%、75%平均时间。结果 与非高温组阿曲库铵用量73.2±9.5mg.kg-1、平均泵速5.1 ±0.9 μg/kg。min-1比较，高温组阿曲库铵用量为123.8±15.7 mg.kg-1（P<0.01，vs 73.2±9.5mg.kg-1）、平均泵速12.5 ±1.7 μg/kg。min-1（P<0.01，vs 5.1 ±0.9 μg/kg。min-1）。非温组，TOF从 10%恢复至 25%、50%、75%的时间分别为8.2±2.5 min，13.8±2.3 min，24.1±3.7 min；高温组，TOF从 10%恢复至 25%、50%、75%的时间分别为4.8±1.3 min（P< 0.01 vs 8.2±2.5 min），8.6±1.7 min（P< 0.05 vs 13.8±2.3 min），14.1±3.2 min（P< 0.01 vs 24.1±3.7 min）。结论 WBH可以增加晚期癌症患者TIVA中阿曲库铵的用量和输注速度，缩短其作用时间。
[Abstract] Objective：To observe the effects of whole-body hyperthermia（WBH）on pharmacodynamics of atracurium in patients with malignant tumor under total intravenous anesthesia. Methods：Fifty patients with advanced cancer were randomly assigned into two groups：hyperthermia group（n=24）and non-hyperthermia group（n=26）. Signs and parameters such as body temperature，electrocardiogram，central venous pressure，pulse oxygen saturation and PETCO2 were monitored during the operation. The TOF mode of stimulation was used to monitor neuromuscular blocking. The dosages of atracurium were observed. The TOF on the time of atracurium withdrawal and the time of 25 %，50 %，75 % recovery from 10% of TOF were recorded. Results：Compared with dosage of atracurium in non-hyperthermia group（73.2±9.5mg.kg-1），the dosage of atracurium in hyperthermia group was 123.8±15.7 mg.kg-1（P< 0.01，vs 73.2±9.5mg.kg-1）. Compared with the infusion speed of atracurium in non-hyperthermia group（5.1 ±0.9 μg/kg。min-1），the dosage of atracurium in hyperthermia group was 12.5 ±1.7 μg/kg。min-1（P< 0.01，vs5.1 ±0.9 μg/kg。min-1）. The 25%、50%、75% of TOF recovery from 10% of TOF in non- hyperthermia group were 8.2±2.5 min，13.8±2.3 min，24.1±3.7 min，respectively；The 25%、50%、75% of TOF recovery from 10% of TOF in hyperthermia group were 4.8±1.3 min（P< 0.01 vs 8.2±2.5 min），8.6±1.7 min（P< 0.05 vs 13.8±2.3 min），14.1±3.2 min（P< 0.01 vs 24.1±3.7 min），respectively. Conclusion：WBH needs high dose of atracurium and facilitates the rapid and complete recovery of function of atracurium.
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