短小全麻手术中米库氯铵与罗库溴铵肌松效应的比较

发布时间：2018-01-15 05:35

本文关键词：短小全麻手术中米库氯铵与罗库溴铵肌松效应的比较　出处：《中国新药与临床杂志》2015年08期 　论文类型：期刊论文

【摘要】：目的评价短小全麻手术中米库氯铵和罗库溴铵的肌松效果及安全性。方法 60例择期行短小手术的患者随机分成两组,每组30例。两组全麻诱导均予依次静脉注射咪达唑仑0.04 mg·kg-1、芬太尼3μg·kg-1、依托咪酯0.3 mg·kg-1,在此基础上米库氯铵组予米库氯铵0.20 mg·kg-1,罗库溴铵组予罗库溴铵0.75 mg·kg-1。采用4个成串刺激(TOF)监测肌松,观察记录两组插管时情况,肌松时效指标及不良反应的发生情况,检测注药前、注药后3 min及插管后5 min血组胺浓度。结果罗库溴铵组患者气管插管条件优于米库氯铵组(P0.05)。米库氯铵组肌松起效时间长于罗库溴铵组,而临床作用时间、恢复指数和完全恢复时间短于罗库溴铵组(P0.05)。注药前和插管后5 min,两组血组胺浓度无显著差异(P0.05),注药后3 min米库氯铵组血组胺浓度高于罗库溴铵组(P0.05)。米库氯铵组内患者出现皮肤潮红18例、心动过速15例、低血压10例,罗库溴铵组分别为1例、3例、1例,组间差异显著(P0.05)。两组均无严重不良反应发生。结论与罗库溴铵比较,米库氯铵用于全麻时虽然起效慢、也可引起短时间的组胺释放,但肌松恢复迅速,较适宜在短小手术中应用。
[Abstract]:Objective to evaluate the effect and safety of myoclonium and rocuronium bromide on myoclonium and rocuronium in short general anesthesia. Methods 60 patients undergoing elective short operation were randomly divided into two groups. 30 cases in each group were induced by midazolam 0.04 mg 路kg -1, fentanyl 3 渭 g 路kg -1 and etomidate 0.3 mg 路kg-1 respectively. On this basis, Micuronium chloride group was given 0.20 mg 路kg-1 of Micuronium chloride and rocuronium group 0.75 mg 路kg -1 of rocuronium. Four strands of stimulation were used to monitor muscle relaxation. Observe and record the condition of intubation, the time index of muscle relaxation and the occurrence of adverse reaction in both groups, and detect before injection. Results the tracheal intubation condition of rocuronium group was better than that of micronium chloride group (P 0.05). The onset time of muscle relaxation in Micuronium chloride group was longer than that in rocuronium group. The clinical action time, recovery index and complete recovery time were shorter than those in rocuronium group (P 0.05). There was no significant difference in serum histamine concentration between the two groups before injection and 5 min after intubation. The serum histamine concentration in the Micuronium chloride group was higher than that in the rocuronium group 3 min after injection (P 0.05). Skin flashes were found in 18 cases, tachycardia in 15 cases and hypotension in 10 cases in the Micuronium chloride group. In rocuronium group, there were 3 cases of rocuronium and 3 cases of rocuronium, and the difference between the two groups was significant (P 0.05). There was no serious adverse reaction in both groups. Conclusion compared with rocuronium, the effect of micronium chloride on general anesthesia is slower than that of rocuronium. Histamine release can also be induced for a short period of time, but muscle relaxation is recovered rapidly, so it is more suitable to be used in short operation.
【作者单位】：中国人民解放军九八医院麻醉科;徐州医学院江苏省麻醉学重点实验室;
【分类号】：R614
【正文快照】： 全麻中有效合理地应用肌松药能为手术提供满意条件、利于呼吸管理,还可加快手术床位周转、节约麻醉药用量、降低经济成本。因短效去极化肌松药琥珀胆碱不良反应较大,目前临床上短小手术的全麻多以中时效肌松药如罗库溴铵(rocuronium)、维库溴铵等使用较为普遍。罗库溴铵是目前

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