摘要
目的观察无肌松药麻醉技术对儿童重症肌无力(MG)患者经胸骨胸腺切除围术期及拔管时间的影响,并与肌松药麻醉技术比较。方法将26例儿童MG患者随机分为肌松药组(M组)和无肌松药组(N组)各13例。所有患者以咪唑安定、丙泊酚和芬太尼麻醉诱导,气道表面麻醉后行气管插管。异丙酚复合七氟醚维持麻醉。M组中麻醉诱导和维持使用少量卡肌宁,N组不使用肌松药。记录两组患者插管条件、血流动力学变化、清醒及拔管时间、术后并发症等。结果所有患者均顺利插管;两组血流动力学变化比较差异无统计学意义(P>0.05),N组插管后收缩压(SBP)和舒张压(DBP)显著低于麻醉前(P<0.05);所有患者均在手术室拔管,无患者因术后呼吸抑制再次插管;两组患者清醒时间比较差异无统计学意义(P>0.05);N组拔管时间显著少于M组(P<0.05);两组患者术后恢复良好,其他观察指标比较差异无统计学意义(P>0.05)。结论无肌松药麻醉技术对儿童MG胸腺切除术患者是一种安全、可靠的麻醉方法,可以缩短患者术后拔管时间,有利于患者迅速恢复。
Objective To compare non-muscle relaxant anesthetic techniques with muscle relaxant anesthetic techniques in pediatric myasthenia gravis（MG） patients undergoing trans-sternal thymectomy and evaluate the intra and postoperative conditions including extubation time in the operating room.Methods Twenty-six pediatric patiens with MG were randomly divided into two groups：non-muscle relaxant（N group,n=13） and muscle relaxant（M group,n=13）.In both groups anesthesia was induced with midazolam,fentanyl and propofol and intubation was performed after topical anesthesia of the airway with lidocaine.Anesthesia was maintained with propofol-sevoflurane.In M group small dose of atracurium was used in induction and maintenance of anesthesia and no neuromuscular blocker in N group.Intubating conditions,hemodynamic changes,wakeup time,extubation time and postoperative complications were evaluated.Results Intubating conditions were good in all patients.There were no significant haemodynamic changes between two groups（P0.05）.The SBP and DBP after induction were lower than these before anesthesia in N group（P0.05）.All patients were extubated in the operating room and none had to be re-intubated for postoperative respiratory depression.There was no significant difference in wakeup time between two groups（P0.05）.The extubation time in N group was shorter than that in M group（P0.05）.At the end of the procedure the recovery was complete in all the patients.There were no other significant differences between the two groups studied.Conclusion The non-muscle relaxant anesthetic technique is safe and feasibile in pediatric myasthenic patients undergoing thymectomy and shorten the time of extubation and speed up recovery.
出处
《重庆医学》
CAS
CSCD
北大核心
2012年第2期150-152,共3页
Chongqing medicine
关键词
麻醉药
全身
重症肌无力
胸腺切除术
儿童
肌松剂
anesthetics
general
myasthenia gravis
thymectomy
children
muscle relaxant
