本文選題：氣腹 + 神經(jīng)肌肉阻滯　； 參考：《復(fù)旦學(xué)報(bào)(醫(yī)學(xué)版)》2017年02期

【摘要】：目的比較腹腔鏡與開腹手術(shù)中單次輸注羅庫溴銨或順式阿曲庫銨后神經(jīng)肌肉阻滯時(shí)間。方法 100例全麻下行擇期婦科手術(shù)的女性患者根據(jù)手術(shù)方式分為2組,各組再隨機(jī)分為羅庫溴銨組和順式阿曲庫銨組,共計(jì)4組,分別為羅庫溴銨開腹組(OR組)、順式阿曲庫銨開腹組(OC組)、羅庫溴銨腹腔鏡組(LR組)和順式阿曲庫銨腹腔鏡組(LC組),每組25例。每位患者均靜脈推注舒芬太尼0.5μg/kg和丙泊酚2 mg/kg,待意識(shí)消失后按組別分別靜脈推注羅庫溴銨0.9 mg/kg或順式阿曲庫銨組0.15 mg/kg。記錄羅庫溴銨或順式阿曲庫銨注射后第1個(gè)成串刺激(T1)出現(xiàn)的時(shí)間及T1恢復(fù)到基礎(chǔ)值的5%和25%的時(shí)間。結(jié)果 OC組和LC組相比,神經(jīng)肌肉阻滯時(shí)間的差異無統(tǒng)計(jì)學(xué)意義。LR組與OR組相比,推注羅庫溴銨后T1出現(xiàn)的時(shí)間、T1恢復(fù)到基礎(chǔ)值的5%及25%的時(shí)間均顯著延長(zhǎng)(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]。結(jié)論需警惕羅庫溴銨用于腹腔鏡手術(shù)時(shí)神經(jīng)肌肉阻滯時(shí)間的延長(zhǎng),必要時(shí)進(jìn)行肌松監(jiān)測(cè)。
[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 鹵4.0)min vs.(44.8 鹵10.7 minutes, 41.8 鹵6.8)min vs.(52.8 鹵11.2 7.5)min vs.(62.6 鹵13.5)min]. Conclusion rocuronium should be used to prolong the time of neuromuscular block and monitor muscle relaxation if necessary.
【作者單位】： 復(fù)旦大學(xué)附屬婦產(chǎn)科醫(yī)院麻醉科;
【基金】：上海市衛(wèi)計(jì)委青年局級(jí)課題(201344196)~~
【分類號(hào)】：R614

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