顺式阿曲库铵联合喉罩在腹腔镜下胆囊切除手术中的应用  

Effect of cis - atracurium combined with laryngeal mask airway in laparoscopic cholecystectomy surgery

作　　者：王其敏[1] 

机构地区：[1]郑州市中心医院麻醉科,450007

出　　处：《中国实用医刊》2011年第14期38-39,共2页Chinese Journal of Practical Medicine

摘　　要：目的探讨不同剂量的顺式阿曲库铵联合喉罩在腹腔镜下胆囊切除手术中应用的药效学特点。方法ASAI～Ⅱ级择期行腹腔镜下胆囊切除手术患者60例，按照静脉注射的顺式阿曲库铵量随机分为三组，A组：0．1mg／kg（2ED95），B组：O．15mg／kg（3ED95），C组：0．2mg／kg（4ED95）。记录三组肌松阻滞时效及术中生命体征变化，观察阻滞起效时间、四个成串刺激（TOF）无反应期、阻滞维持时间、肌松恢复指数与体内作用时间。结果不同剂量的顺式阿曲库铵对心率及血压无明显的影响；与A组比较，B组和C组的起效时间较短（P〈0．01），TOF无反应期、阻滞维持时间及体内作用时间较长（P〈0．01）；B组和C组的起效时间比较差异无统计学意义，与B组比较，C组的TOF无反应期、阻滞维持时间及体内作用时间较长（P〈0．01），三组的肌松恢复指数比较差异无统计学意义。结论顺式阿曲库铵联合喉罩用于腹腔镜下胆囊切除手术安全有效，4ED95与3ED95剂量比较并不能缩短起效时间。Objective To investigate the pharmacodynamic characteristics of different doses of cis -atracurium combined with laryngeal mask airway in laparoscopic cholecystectomy. Methods Sixty cases of ASA grade I - II selective laparoscopic cholecystectomy patients were randomly divided into 3 groups, group A ：0.1 mg/kg （ two x effective dose）, group B ：0.15 mg/kg （ three × effective dose） and group C ：0.2 mg/kg （4 × effective dose）. Neuromuscular block time and intraoperative vital signs chan- ges, onset time, duration of peak effect, duration of clinical action, duration of total action and recovery index of the three groups were recorded. Results There was no significant effect of different doses of cisatracurium on heart rate and blood pressure, compared with group A, group B and group C has a shorter onset time（ P 〈0.01 ） ; And has a longer duration of peak effect,duration of clinical action and duration of total action（ P 〈0.01 ） ; There was no significant effect of onset time of group A and group B, compared with group B, group C has a longer duration of peak effect, duration of＇ clinical action and duration of total action（ P 〈 0.01 ）, there was no significant effect of the recovery index of three groups. Conclusions Cis -atracurium combined with laryngeal mask for laparoscopic cholecystectomy is safe and effective, compared with 3ED95, 4ED95 dose can＇t reduce the onset time.

关 键 词：顺式阿曲库铵 喉罩 腹腔镜胆囊切除术 

分 类 号：R614[医药卫生—麻醉学]