摘要
目的比较米库氯铵、顺苯磺酸阿曲库铵在腹腔镜胆囊手术中维持肌肉松弛的作用。方法将2011年8月至2014年2月中南大学湘雅医院择期行腹腔镜胆囊手术的320例患者按随机数字表法分为观察组和对照组,各160例。术前采用咪达唑仑、瑞芬太尼、丙泊酚以及琥珀胆碱进行麻醉诱导,术中泵注丙泊酚、瑞芬太尼维持麻醉,并对观察组和对照组患者分别泵注1000μg/m L的米库氯铵和顺苯磺酸阿曲库铵。两组患者均常规不使用肌肉松弛拮抗药,以观察肌肉松弛自主恢复情况。结果观察组恢复指数(4.0±1.8)明显短于对照组(9.3±4.8),差异有统计学意义(P<0.01);观察组拔管时间亦明显短于对照组[(19±5)min比(32±7)min],差异有统计学意义(P<0.01);对照组和观察组患者在肌肉松弛恢复过程中,各监测时点的脉搏血氧饱和度、心率、平均动脉压比较差异均无统计学意义(P>0.05)。结论腹腔镜胆囊切除术中应用米库氯铵具有肌肉松弛效果好、不良反应小、恢复时间短、拔管时间短等特点,可在临床推广应用。
Objective To compare the function of mivacurium and cisatracurium for muscle relaxing in laparescopic cholecystectomy. Methods Total of 320 patients for laparoscopic cholecystectomy in Xiangya Hospital of Central South University from Aug. 2011 to Feb. 2014 were divided into observation group and control group randomly ,each group 160 patients. Anesthesia induction was provided with midazolam, fenta- nyl, propofol and anectine before operation. During surgery, propofol and fentanyl were injected for mainte- nance. And 1000 μg/mL mivacurium and cisatracurium were injected through venous pump in the observa- tion group and the control group respecitvely. Muscle relaxation antagonists were not used conventionally, so as to observe independent muscle relaxation. Results Index of recovery index in the observation group （4. 0 ± 1.8） was significantly shorter than that in the control group（9.3 ±4. 8） （P 〈 0. 01 ）. And time of extubation in the observation group was significantly shorter than that in the control group [ （19 ± 5 ） rain vs （32 ± 7 ） min] （ P 〈 0.01 ） ;in the process of muscle relaxation, there were no statistical differences in pulse oxygen saturation, heart rate, mean arterial pressure of different time points in both groups （ P 〉 0. 05 ）. Conclusion In the laparoscopic cholecysteetomy, mivacurium chloride used for anesthesia has advantages of good effect of muscle relaxation, small adverse reactions, short recovery time and short extubation time,thus is worthy of expansion and application in clinical.
出处
《医学综述》
2015年第22期4171-4172,4177,共3页
Medical Recapitulate
