本文關(guān)鍵詞： 順阿曲庫銨 間斷靜脈注射 持續(xù)靜脈輸注 腹腔鏡下胃腸腫瘤手術(shù) 肌肉松馳 老年患者　出處：《上海醫(yī)學(xué)》2015年06期 　論文類型：期刊論文

【摘要】：目的比較行腹腔鏡下胃腸腫瘤手術(shù)的老年患者間斷與持續(xù)靜脈注射順阿曲庫銨兩種不同給藥方式對(duì)肌肉松弛效應(yīng)的影響。方法選擇在全身麻醉下行腹腔鏡下胃腸腫瘤手術(shù)的老年患者60例,美國麻醉醫(yī)師協(xié)會(huì)(ASA)分級(jí)Ⅰ或Ⅱ級(jí),隨機(jī)分入間斷給藥組和持續(xù)給藥組,每組30例。麻醉誘導(dǎo)后,間斷給藥組患者根據(jù)手術(shù)需要間斷靜脈給藥,持續(xù)給藥組患者經(jīng)靜脈輸液泵持續(xù)給藥,應(yīng)用肌肉松弛監(jiān)測(cè)儀觀察術(shù)中肌肉松弛情況,當(dāng)4個(gè)成串刺激(TOF)中第1個(gè)顫搐幅度(T1)恢復(fù)至10%時(shí),間斷給藥組患者靜脈注射順阿曲庫銨0.03mg/kg,持續(xù)給藥組經(jīng)靜脈輸液泵注射阿曲庫銨1.4\mg·kg-1·min-1。監(jiān)測(cè)麻醉誘導(dǎo)后T1首次恢復(fù)到10%的時(shí)間(10%時(shí)間)、最后1次給藥(停止持續(xù)給藥)至TOF恢復(fù)到70%的時(shí)間(70%時(shí)間)、TOF從70%恢復(fù)到90%的時(shí)間(90%時(shí)間)、恢復(fù)指數(shù)(TOF從25%恢復(fù)至75%的時(shí)間)和肌肉松弛藥總用藥量。結(jié)果兩組間手術(shù)時(shí)間、10%時(shí)間、90%時(shí)間的差異均無統(tǒng)計(jì)學(xué)意義(P值均0.05)。持續(xù)給藥組的70%時(shí)間顯著短于間斷給藥組(P0.01),恢復(fù)指數(shù)、總用藥量和平均靜脈注射速度均顯著低于間斷給藥組(P值分別0.05、0.01)。結(jié)論持續(xù)靜脈注射順阿曲庫銨能減少老年患者行腹腔鏡下胃腸腫瘤手術(shù)時(shí)的順阿曲庫銨用藥量,有利于術(shù)后肌肉松弛的恢復(fù)。
[Abstract]:Objective to compare the effects of intermittent and continuous intravenous administration of cisatracurium on muscle relaxation in elderly patients undergoing laparoscopic gastrointestinal tumor surgery. Methods Laparoscopic gastroenteroscopy was performed under general anesthesia. 60 elderly patients underwent tumor surgery. The American Association of Anesthesiologists (ASA) grade 鈪，

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