摘要
目的术后肌松药残留会导致呼吸功能不全,本研究拟评估舒更葡糖钠与新斯的明对电视胸腔镜肺叶切除术患者罗库溴铵肌松作用的拮抗效果,并评估二者对患者术后肺部并发症的影响。方法选取2021年9月—2022年12月拟在青海大学附属医院行择期电视胸腔镜肺叶切除术的患者共计90例,按照随机数字表法分为舒更葡糖钠组(S组)和新斯的明组(N组),每组各45例。S组静脉注射舒更葡糖钠2 mg/kg;N组静脉注射新斯的明0.05 mg/kg(最大剂量5 mg)+阿托品0.02 mg/kg。记录患者拔管时间、麻醉后监护室(PACU)停留时间、术后住院时间和总住院时间;于入PACU后15 min评估患者各部位肌力;比较术后肺部感染等不良反应发生情况。结果S组拔管时间、PACU停留时间分别为8.1(6.1,10.9)min、11.8(8.9,19.7)min,明显短于N组[8.6(6.4,16.5)min、13.3(10.0,23.9)min],差异均有统计学意义(Z=2.089、2.853,P<0.05)。S组抬头成功人数、握持成功人数明显多于N组,差异有统计学意义(P<0.05)。S组完成凝视的人数(43例)明显多于N组(38例),差异均有统计学意义(P<0.05)。2组术后不良反应发生率比较差异无统计学意义(P>0.05)。结论与新斯的明相比,舒更葡糖钠更有助于拮抗电视胸腔镜肺叶切除术患者罗库溴铵的肌松效果,但对术后肺部并发症无明显改善。
Objective Postoperative muscle relaxant residue can lead to respiratory insufficiency,the aim of this study was to evaluate the antagonistic effects of sugammadex sodium and neostigmine on the muscular release of rocuronium in patients undergoing video-assisted thoracoscopic lobectomy,as well as their impact on postoperative pulmonary complications.Methods A total of 90 patients who planned to undergo elective video-assisted thoracoscopic lobectomy in the Affiliated Hospital of Qinghai University from September 2021 to December 2022 were selected,and they were randomly assigned to either the sugammadex sodium group(group S)or neostigmine group(group N)using a random number table method,with 45 cases in each group.Group S was intravenously injected with sugammadex sodium 2 mg/kg,while Group N received an intravenous injection with neostigmine 0.05 mg/kg(maximum dose 5 mg)and atropine 0.02 mg/kg.Extubation time,post-anesthesia cave unit(PACU)stay time,postoperative length of hospitalization,and total length of hospitalization were compared.Muscle strength in each part of the patient was assessed 15 min after admission to PACU.Postoperative pulmonary infection and other adverse reactions were compared.Results The extubation time and PACU residence time in group S were 8.1(6.1,10.9)min,11.8(8.9,19.7)min,respectively,which were statistically shorter than those in group N[8.6(6.4,16.5)min,13.3(10.0,23.9)min],and the differences were statistically significant(Z=2.089,2.853,P<0.05).The number of patients in group S with head raising and holding was significantly higher than that in the N group(P<0.05).The number of patients in group S who can track object with eyes was statistically higher than that in group N(P<0.05).There was no significant difference in the incidence of postoperative adverse reactions between 2 groups(P>0.05).Conclusion Compared with neostigmine,sugammadex sodium antagonized the muscle relaxation effect of rocuronium in patients with video-assisted thoracoscopic lobectomy but did not reduce the risk o
作者
袁永瑾
唐璟
范忠敏
马臻杰
YUAN Yongjin;TANG Jing;FAN Zhongmin;MA Zhenjie(Department of Anesthesiology,Affiliated Hospital of Qinghai University,Xining,Qinghai 810001,China;不详)
出处
《中华全科医学》
2024年第8期1313-1316,共4页
Chinese Journal of General Practice
基金
青海省卫生健康委指导性计划课题(2021-wjzdx-59)
青海大学附属医院中青年科研基金项目(ASRF-2021-YB-03)。
关键词
舒更葡糖钠
新斯的明
电视胸腔镜肺叶切除术
罗库溴铵
肺部并发症
Sugammadex sodium
Neostigmine
Video-assisted thoracoscopic lobectomy
Rocuronium
Pulmonary complications
