摘要
目的观察不同麻醉方法对腹腔镜胆囊切除术患者维库溴铵肌松效应的影响。方法选择80例腹腔镜胆囊切除术患者,ASAⅠ～Ⅱ级。随机分为经穴组(针刺经穴复合全麻组)、非经非穴组(针刺非经非穴复合全麻组)、全麻组。三组患者均采用芬太尼3μg.kg-1、异丙酚2 mg.kg-1、维库溴铵0.1 mg.kg-1进行全麻诱导,术中以静脉血浆靶控输注异丙酚,间断静脉注射芬太尼、维库溴铵维持麻醉。经穴组选取双侧合谷、内关、足三里、阳陵泉、曲池,非经非穴组选用经穴组每个经穴所在经脉与外侧相邻经脉连线的中点,与经穴相平处取穴,进针得气后持续电针刺激,直至术毕。应用肌松监测仪持续监测维库溴铵的显效时间、起效时间、维持时间和恢复指数。并记录术中麻醉药用量及术后清醒时间、拔管时间和定向时间。结果三组的肌松效应中显效时间、起效时间、恢复指数无显著差异(P>0.05),而经穴组的维持时间与全麻组比较差异有统计学意义(P<0.05)。经穴组与全麻组比较术中麻醉药用量明显减少(P<0.05)。经穴组术后清醒时间、拔管时间和定向时间显著缩短(P<0.01)。结论针刺经穴复合全麻可延长肌松药的维持时间,减少术中麻醉药的用量,患者术后恢复快,有利于患者尽早康复。
Objective To observe the effects of different anesthesia approaches on the muscle relaxation of vecuronium in patients undergoing laparoscopic cholecystectomy（LC）.Methods Eighty patients were randomized into three groups： acupoint group（acupuncture combined general anesthesia by using acupoints）,non-acupoint group（acupuncture combined general anesthesia by using non-acupoints） and general anesthesia group.Anesthesia was induced by using Fentanyl 3 μg·kg-1,propofol 2 mg·kg-1 and vecuronium 0.1 mg·kg-1 in all the groups.Target controlled infusion of propofol and intravenous injection of fentanyl and vecuronium were used to maintain the anesthesia condition.In the acupoint group,bilateral Hegu（LI 4）,Neiguan（PC 6）,Zusanli（ST 36）,Yanglingquan（GB 34） and Quchi（LI 11） were selected to receive acupuncture and subsequent electro-stimulation after qi arrival,till the end of the operation;for the non-acupoint group,same procedure was applied but with non-acupoints,which were located at the midpoints between the selected acupoint and the point of the adjacent meridian.Muscle relaxation detector was used in measuring the effect time,onset time,and maintenance time as well as the recovery index.The dose of anesthetics,the time to recovery,extubation time,and orientation time were all noted.Result Regarding to the muscle relaxation effect of the three groups,the comparison of effect time,onset time and recovery index did not show significant differences（P0.05）,while the comparison of maintenance time between the acupoint group and general anesthesia group showed significant difference（P0.05）.Compared with the general anesthesia group,the acupoint group used notably smaller dose of anesthetics（P0.05）,and it took significantly shorter time in comparison of the time to recovery,extubation time and orientation time（P0.05）.Conclusion Acupuncture combined general anesthesia prolongs the maintenance time of the muscle relaxant,reduces the anesthetics dose,and contributes to the ear
出处
《上海针灸杂志》
2011年第4期227-229,共3页
Shanghai Journal of Acupuncture and Moxibustion
基金
上海市卫生局中医药科研基金资助(2008L054A)
关键词
针刺麻醉
针刺复合全麻
维库溴铵
肌松效应
Acupuncture anesthesia
Acupuncture combined anesthesia
Vecuronim bromide
Muscle relaxation
