腹腔镜与开腹手术中单次输注罗库溴铵或顺式阿曲库铵后神经肌肉阻滞时间的比较

发布时间：2018-05-22 10:33

本文选题：气腹 + 神经肌肉阻滞　；参考：《复旦学报(医学版)》2017年02期

【摘要】：目的比较腹腔镜与开腹手术中单次输注罗库溴铵或顺式阿曲库铵后神经肌肉阻滞时间。方法 100例全麻下行择期妇科手术的女性患者根据手术方式分为2组,各组再随机分为罗库溴铵组和顺式阿曲库铵组,共计4组,分别为罗库溴铵开腹组(OR组)、顺式阿曲库铵开腹组(OC组)、罗库溴铵腹腔镜组(LR组)和顺式阿曲库铵腹腔镜组(LC组),每组25例。每位患者均静脉推注舒芬太尼0.5μg/kg和丙泊酚2 mg/kg,待意识消失后按组别分别静脉推注罗库溴铵0.9 mg/kg或顺式阿曲库铵组0.15 mg/kg。记录罗库溴铵或顺式阿曲库铵注射后第1个成串刺激(T1)出现的时间及T1恢复到基础值的5%和25%的时间。结果 OC组和LC组相比,神经肌肉阻滞时间的差异无统计学意义。LR组与OR组相比,推注罗库溴铵后T1出现的时间、T1恢复到基础值的5%及25%的时间均显著延长(P0.05)[(36.2±4.0)min vs.(44.8±10.7)min,(41.8±6.8)min vs.(52.8±11.2)min,(49.5±7.5)min vs.(62.6±13.5)min]。结论需警惕罗库溴铵用于腹腔镜手术时神经肌肉阻滞时间的延长,必要时进行肌松监测。
[Abstract]:Objective to compare the time of neuromuscular block after single infusion of rocuronium or cis atracurium during laparoscopic and open surgery. Methods 100 female patients undergoing elective gynecological surgery under general anesthesia were divided into two groups according to the operation mode. Each group was randomly divided into rocuronium group and cis atracurium group, with a total of 4 groups. They were rocuronium open group (OR group), cis atracurium open group (OC group), rocuronium laparoscopy group (LR-group) and cis atracurium laparoscopy group (LC group) with 25 cases in each group. Each patient was given sufentanil 0.5 渭 g/kg and propofol 2 mg / kg. After consciousness disappeared, rocuronium 0.9 mg/kg or cis atracurium 0.15 mg / kg were injected intravenously. After injection of rocuronium or cis atracurium, the time of the first strands of stimulation T1 and the time of T1 returning to the base value were recorded. Results there was no significant difference in neuromuscular block time between OC group and LC group. Compared with OR group, 5% and 25% of the time of T1 appeared after rocuronium injection were significantly prolonged (P 0.05) [36.2 卤4.0)min vs.(44.8 卤10.7 minutes, 41.8 卤6.8)min vs.(52.8 卤11.2 7.5)min vs.(62.6 卤13.5)min]. Conclusion rocuronium should be used to prolong the time of neuromuscular block and monitor muscle relaxation if necessary.
【作者单位】：复旦大学附属妇产科医院麻醉科;
【基金】：上海市卫计委青年局级课题(201344196)~~
【分类号】：R614

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