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Purpose sevoflurane can enhance the muscle relaxant effect of cis-atracurium, affecting patients restore muscle relaxants. In order to explore the different concentrations of sevoflurane on cis-atracurium muscle relaxation, we studied the combination of the different concentrations of sevoflurane cis atracurium the patient nerve - changes in the degree of neuromuscular block, to guide static suck composite anesthesia cis atracurium dosage to prevent postoperative residual muscle relaxant. Method of anesthesia for elective surgery 60 patients, ASA Ⅰ ~ Ⅱ grade, age 18 to 60 years old, weight 18 to 30kg / m 2 . Exclusion criteria: heart, lung, liver, renal abnormalities, a history of neuromuscular disease, severe anemia, or preoperative taking drugs affecting muscle relaxants, have a personal or family history of malignant hyperthermia, recent burns or severe trauma history, neuromuscular blockers susceptible chronic alcoholics or drug abuse history, body mass index greater than 30kg / m 2 or less than 18kg / m 2 . 60 patients were randomly divided into four groups (n = 15 each): propofol group (P group), 1% sevoflurane group (S 1 group), 1.5% sevoflurane group (S 1.5 group), 2% sevoflurane group (S 2 group). Established after the burglary forearm venous access, routine monitoring of ECG, blood pressure, pulse oximetry. Anesthesia induced by intravenous injection of fentanyl 2 ~ 4ug/kg, propofol 1.5 to 2 mg / kg, and succinylcholine 1mg/kg the trachea experts before tracheal intubation surface anesthesia, oral or nasal endotracheal intubation. P group after the induction of anesthesia with propofol - remifentanil combined 67% nitrous oxide anesthesia was maintained S 1 group S 1.5 group, S 2 group inhaled 1%, 1.5%, 2% concentration of sevoflurane combined 67% nitrous oxide to maintain anesthesia, fentanyl 0.05mg or 0.1mg intravenously given needed. All patients underwent mechanical ventilation, adjust the tidal volume, respiratory rate, end-tidal carbon dioxide partial pressure was maintained at 4 to 5 kPa. Anesthesia was maintained for 35 min, the groups are intravenous injection of cis-atracurium 0.15 mg / kg. Of TOF-WATCHSX (Organon Company, the Netherlands) acceleration neuromuscular monitoring instrument line monitoring of muscle relaxants, current intensity of 50mA T 1 muscle twitching scaling 100% four clusters of stimulation (TOF ) monitoring stimulus interval 12s, recorded from intravenous cis atracurium finished to 0 to T 1 twitch (T 0 , ie onset time), clinical duration of action (from the end of the injection to T 1 twitch recovery to 25% of the time), T 1 twitch recovery to 50%, 90% time (RT 50 , RT , 90 ) and recovery index (RI the RT 25 to RT 75 time). Results of the general situation of the patients are shown in Table 1, among the groups of gender, age, body mass index, albumin was no significant difference (P> 0.05); compared with the P group, S 2 group T < shorten the sub> 0 S 1 S 1.5 S 2 the group clinical role of time, RT , 50 , RT 90 , RI extend (P <0.05); S 1 group compared to the S 1.5 S 2 group clinical duration of action, RT 50 , RT , 90 extend (P <0.05); S 1.5 group compared, S 2 group clinical role time RT 50 RT 90 RI difference was not statistically significant (P> 0.05). Conclusion Compared with propofol, inhalation of 2% sevoflurane can shorten the time of onset of the cis-atracurium, inhalation of 1%, 1.5%, 2% sevoflurane can extend the cis-atracurium clinical effects and recovery time, compared with inhalation of 1% sevoflurane inhalation of 1.5% to 2% sevoflurane extend cis atracurium clinical duration of action and recovery time. In clinical anesthesia, the interaction between the sevoflurane and cis-atracurium should not be overlooked, sevoflurane can enhance the muscle relaxant effect of cis-atracurium, surgery should be based on the actual situation of the patient, the correct estimate the patient's nerves - the degree of neuromuscular block, cis-atracurium dose and dosing interval flexibility, neurological surgery - as soon as possible to restore muscle function.
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