罗库溴铵及顺式阿曲库铵与琥珀胆碱用于电休克治疗肌松效果的比较

发布时间：2018-08-22 15:42

【摘要】：目的：探讨精神疾病患者在麻醉状态下接受电休克治疗，，使用不同种类肌松药既罗库溴铵、顺式阿曲库铵与琥珀胆，对其肌松效果、对患者血流动力学影响及不良反应事件的比较。方法：选择确诊为精神疾病、有明确电休克治疗适应症、ASA分级I级、年龄18~50岁、一周接受3次电休克治疗且平均总疗程至少接受6次治疗的患者60例，随机分为三组：0.45mg/kg（R组）罗库溴铵、0.075mg/kg（C组）顺式阿曲库铵和1mg/kg琥珀胆碱（S组）配伍丙泊酚(1mg/kg)用作麻醉诱导,待患者意识消失且肌肉松弛后行电休克治疗，电抽搐治疗后罗库溴铵组和顺式阿曲库铵组给予甲硫酸新斯的明（0.1mg/kg)加硫酸阿托品(0.05mg/kg）拮抗肌松药，琥珀胆碱组不予处理。比较三组患者治疗后自主呼吸恢复时间、患者自行睁眼及肢体运动时间以及电击前与电击时心率、血压及血氧饱和度的变化。结果：1）对血流动力学及呼吸的影响：三组电抽搐前后心率、收缩压及血氧饱和度差值无差异（p0.05)；舒张压差值三组有统计学差异（p0.05），且R组与S组较C组水平高。2）临床肌松效果比较：起效时间三组有统计学差异（p0.05）,C组较其他两组水平高；自主呼吸恢复时间与患者肢体运动时间三者无差异（p0.05)；睁眼时间C组较其他两组水平高（p0.05）。结论：罗库溴铵、顺式阿曲库铵复合使用肌松拮抗药均可作为琥珀胆碱的替代药物运用于无抽搐电休克治疗。
[Abstract]:Objective: to investigate the effect of electroshock therapy on patients with mental illness under anaesthesia, using rocuronium, cis atracurium and amber gallbladder, and using different kinds of muscle relaxants. Comparison of hemodynamic effects and adverse events in patients. Methods: sixty patients with definite indication of electroshock treatment (ASA grade I), aged 1850 years, received three times of electroshock therapy a week and received at least 6 times of treatment in an average total course of treatment were selected. Three groups were randomly divided into three groups: rocuronium 0.075 mg / kg (group C) and 1mg/kg succinylcholine (S group) combined with propofol (1mg/kg) for anesthesia induction. After electroconvulsive therapy, rocuronium group and cis atracurium group were treated with 0.1mg/kg plus atropine sulfate (0.05mg/kg), but not in succinylcholine group. The time of spontaneous respiration recovery, the time of spontaneous eye opening and limb movement, the changes of heart rate, blood pressure and blood oxygen saturation before and after electric shock were compared among the three groups. Results the effect of 1) on hemodynamics and respiration: there was no difference in heart rate, systolic blood pressure and oxygen saturation between the three groups before and after electric convulsion (p0.05). The difference of diastolic blood pressure in three groups was statistically different (p0.05), and the clinical muscle relaxation effect of group R and group S was higher than that of group C (p0.05). There was no difference between the recovery time of spontaneous respiration and the time of limb movement (p0.05), but the time of eye opening in group C was higher than that in the other two groups (p0.05). Conclusion: rocuronium combined with cis-atracurium can be used as a substitute for succinylcholine in the treatment of convulsive electroshock.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R614

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