摘要
目的 评价靶控输注罗库溴铵用于梗阻性黄疸手术病人的药效动力学。方法 我院2020年8月~2021年8月因梗阻性黄疸拟在全身麻醉下行开腹胆胰手术病人60例,运用随机数字化表法分为两组,观察组30例,采用靶控输注罗库溴铵;对照组30例,采用间断静脉注射罗库溴铵,比较两组病人罗库溴铵诱导期插管总剂量、起效时间、肌松恢复时间、维持用量以及总药量,观察两组病人麻醉维持期间的肌松监测指标。结果 观察组诱导插管的起效时间明显长于对照组,诱导插管剂量明显大于对照组,差异有统计学意义(P<0.01);停药后靶控输注组T1恢复至25%、75%、90%的时间以及恢复指数短于对照组,差异有统计学意义(P<0.01);观察组病人的罗库溴铵单位时间维持用药量以及手术期间总用药量少于对照组,差异有统计学意义(P<0.01);靶控输注下,医生肌松满意程度更高(P<0.01)。结论 靶控输注罗库溴铵不适合梗阻性黄疸病人的麻醉诱导插管,但适合术中维持,能减少术中肌松药用量,降低术后肌松残余的发生率。
Objective To evaluate the pharmacodynamics of target-controlled infusion of rocuronium in patients undergoing surgery for obstructive jaundice.Methods Sixty patients undergoing elective open biliopancreatic surgery under general anesthesia in our hospital from August 2020 to August 2021 were selected and randomly divided into two groups: 30 patients received targeted infusion of rocuronium(observation group),30 patients received intermittent intravenous injection of rocuronium(control group).The total intubation dose, onset time, muscle relaxation recovery time, maintenance dosage and total dosage of rocuronium during induction were compared between the two groups, and the muscle relaxation monitoring indexes during anesthesia maintenance were observed between the two groups.Results The induction time of target-controlled infusion rocuronium was significantly longer than that of intravenous infusion group, and the induction dose of rocuronium was significantly higher than that of intravenous injection group(P<0.01).The time of T1 recovery to 25%,75%,90% and recovery index in the target-controlled infusion group were significantly shorter than that of intravenous injection group after drug withdrawal(P<0.01).The amount of rocuronium per unit time maintenance and total amount of rocuronium during operation were significantly decreased in the target-controlled infusion group(P<0.01).Surgeons’ satisfaction with muscle relaxation was higher under target-controlled infusion(P<0.01).Conclusion Target-controlled infusion of rocuronium is not suitable for induction in patients with obstructive jaundice, but the maintenance of target-controlled infusion is more suitable for such patient, which may reduce the amount of intraoperative muscle relaxants, reduce postoperative residual muscle relaxants, and promote rapid recovery of patients.
作者
陈昊
管少迪
谭茜
鲁佩
徐卉
CHEN Hao;GUAN Shaodi;TAN Xi(Department of Anesthesiology,Tongji Hospital,Tongji Medical School,Huazhong University of Science and Technology,Wuhan 430030,China)
出处
《临床外科杂志》
2022年第9期893-895,共3页
Journal of Clinical Surgery
关键词
梗阻性黄疸
罗库溴铵
靶控输注
obstructive jaundice
rocuronium
target-controlled infusion
