摘要
目的探讨全静脉麻醉下妇科腹腔镜手术中不追加肌松药的可行性。方法 108例全静脉麻醉下妇科腹腔镜手术患者,随机分为实验组和对照组,实验组患者在诱导气管内插管后不再追加肌松药-阿曲库铵,对照组按常规间隔35～40 min追加阿曲库铵0.3 mg/kg,观察有无人机对抗和体动反应,比较气腹前、气腹后、放气后气道压的变化,术者对麻醉的满意度以及患者在复苏室停留时间。结果两组患者均无人机对抗和体动反应;术者对所有患者的麻醉表示满意;气腹前后气道峰压变化明显(P<0.05),但是两组间各相对应时点气道峰压相比,差异无统计学意义(P>0.05)。实验组在复苏室停留时间短于对照组(P<0.05)。结论全静脉麻醉下妇科腹腔镜手术中不追加肌松药,不会加剧气腹后气道压的升高,对手术操作无影响,可以缩短患者在术后恢复室的停留时间。
Objective To study the feasibility of using a single intubating dose of atracurium,without administering incremental doses of atracurium during the maintenance of total intravenous anaesthesia in gynecology patients undergoing laparoscopic surgery.Methods One hundred and eight patients,ASA physical status I-II,scheduled for gynaecological laparoscopy were randomly assigned to two groups with 54 cases each ： experimental group（group E） and control group（group C）.All the patients were induced with midazolam-etomide-atracurium-fentanil,pump-infusion propofol and remifentanil to obtaining a stable BIS value ranging between 40～50.During the maintenance of total intravenous anaesthesia.patients in the group E did not receive any doses of atracurium,while patients in group C received incremental doses of atracurium 35～40 min after the former administration of atracurium.The incidence of patients breathing against ventilator and body movements,Satisfaction of surgeons were evaluated,changes of airway peak pressure,postanesthesia care unit stay time were compared.Results There were no significant differences between the two groups for satisfaction of surgeons as well as the incidence of patients breathing against ventilator and body movement（P0.05）,the airway peak pressure increased after peritoneal inflation and decreased after abdominal deflation in both groups（P0.05）,however,there were no significant differences for the airway peak pressure at the corresponding time point between the two groups（P0.05）.Postanesthesia care unit stay time was shorter in group E than in group C（P0.05）.Conclusion In gynecology patients undergoing laparoscopic surgery,it is feasible to maintain total intravenous anaesthesia without administering incremental doses of atracurium after induction and this anesthetic technique is associated with a shorter postanesthesia care unit stay time.
出处
《中国实用医药》
2012年第4期22-23,共2页
China Practical Medicine
关键词
全静脉麻醉
腹腔镜手术
阿曲库铵
Total intravenous anaesthesia
Laparoscopic surgery
Atracurium
