不同诱导剂量顺式阿曲库铵对甲状腺癌患者术中喉返神经监测的影响
发布时间：2018-07-31 15:55
【摘要】：目的:比较使用不同诱导剂量的顺式阿曲库铵对甲状腺癌患者术中监测喉返神经功能的影响。方法:择期行喉返神经监测的甲状腺癌患者1 5 0例,年龄3 0-6 0岁,A S A分级Ⅰ-Ⅱ级,根据顺式阿曲库铵诱导剂量的不同随机分三组,每组5 0例。麻醉诱导:咪达唑仑0.0 3 m g/k g,丙泊酚2-3 m g/k g,芬太尼3-4μg/k g,和顺式阿曲库铵0.0 5 m g/k g(A组)、0.1 m g/k g(B组)、0.1 5 m g/k g(C组),3 m i n后且N a r c o t r e n d值4 6时经喉镜明视气管插管(喉返神经监测导管)并机械通气。术中微量泵泵入丙泊酚、瑞芬太尼和吸入七氟醚维持麻醉。记录三组患者一般资料如性别比例、年龄、体重和手术时间;记录插管时喉镜暴露分级(C o r m a c h-L e h a n e,C-L)情况:Ⅰ-Ⅳ级例数;记录从给完顺式阿曲库铵到喉返神经暴露的时间(T 1)、到第一次监测有喉返神经电信号的时间(T 2);记录给完顺式阿曲库铵后4 0 m i n(T 3)、5 0 m i n(T 4)、6 0 m i n(T 5)、7 0 m i n(T 6)各时间点刺激侧喉返神经电信号的波峰值。结果:三组患者一般资料如性别比例、年龄、体重和手术时间的比较差异均无统计学意义(P0.0 5)。与A组相比,B组插管时C-L分级为Ⅱ级的比例明显升高,Ⅲ级比例明显降低,差异有统计学意义(P0.0 5);与A组相比,C组插管时Ⅰ级的比例明显升高,Ⅲ级比例明显降低,差异有统计学意义(P0.0 5);与B组相比,C组插管时Ⅰ级的比例明显升高,Ⅱ级的比例明显降低,差异有统计学意义(P0.0 5)。与A组相比,C组T 2时间明显延长(P0.0 5),在T 3时无电信号,在T 4、T 5时喉返神经电信号波峰值均显著减小(P0.0 5);与B组相比,C组T 2时间明显延长(P0.0 5),在T 3时无电信号,在T 4、T 5时喉返神经电信号波峰值均显著减小(P0.0 5);而A、B两组的T 1、T 2值及在T 3-6各时间点电信号波峰值均接近,差异无统计学意义(P0.0 5)。结论:麻醉诱导使用剂量为0.1 m g/k g,即2倍9 5%有效剂量(9 5 p e r c e n t e f f e c t i v e d o s e,E D 9 5)的顺式阿曲库铵适宜于甲状腺癌患者术中行喉返神经功能的监测。
[Abstract]:Aim: to compare the effects of different induced doses of cis-atracurium on intraoperative monitoring of recurrent laryngeal nerve function in patients with thyroid carcinoma. Methods: 150 patients with thyroid carcinoma, aged 30 to 60 years old, were randomly divided into three groups according to the different doses of cis-atracurium induction. Anesthesia induction: midazolam 0.03 mg / k g, propofol 2-3 mg / k g, fentanyl 3-4 渭 g / k g, cis atracurium 0.05 mg / k g (A) 0.1 mg / k g (B) 0.1 mg / k g (C) 3 m i n and N a r c o t r e n d 4.6 Tracheal intubation via laryngoscope (recurrent laryngeal nerve monitoring catheter) and mechanical ventilation. Intraoperative micropump infusion of propofol, remifentanil and sevoflurane maintenance anesthesia. The general data such as sex ratio, age, weight and operation time were recorded in the three groups, and the laryngoscopic exposure grade (C o r m a c h-L e h a n eosin C-L was recorded at the time of intubation: 鈪，
本文编号：2156072
[Abstract]:Aim: to compare the effects of different induced doses of cis-atracurium on intraoperative monitoring of recurrent laryngeal nerve function in patients with thyroid carcinoma. Methods: 150 patients with thyroid carcinoma, aged 30 to 60 years old, were randomly divided into three groups according to the different doses of cis-atracurium induction. Anesthesia induction: midazolam 0.03 mg / k g, propofol 2-3 mg / k g, fentanyl 3-4 渭 g / k g, cis atracurium 0.05 mg / k g (A) 0.1 mg / k g (B) 0.1 mg / k g (C) 3 m i n and N a r c o t r e n d 4.6 Tracheal intubation via laryngoscope (recurrent laryngeal nerve monitoring catheter) and mechanical ventilation. Intraoperative micropump infusion of propofol, remifentanil and sevoflurane maintenance anesthesia. The general data such as sex ratio, age, weight and operation time were recorded in the three groups, and the laryngoscopic exposure grade (C o r m a c h-L e h a n eosin C-L was recorded at the time of intubation: 鈪，
本文编号：2156072
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