1倍ED95罗库溴铵用于麻醉诱导对甲状腺手术患者术中喉返神经监测的影响  

Effect of rocuronium 0：3 mg/kg （ED95） for anesthesia induction on monitoring of recurrent laryngeal nerve in patients undergoing thyroid surgery

作　　者：陈鹏[1] 梁枫[1] 苏振波[1] 李龙云[1] 赵国庆[1] 

机构地区：[1]130033长春市,吉林大学中日联谊医院麻醉科

出　　处：《中华麻醉学杂志》2012年第5期525-527,共3页Chinese Journal of Anesthesiology

摘　　要：目的评价1倍ED95，罗库溴铵用于麻醉诱导对甲状腺手术患者术中喉返神经监测的影响。方法择期甲状腺手术患者75例，性别不限，年龄20～70岁，体重50～85kg，ASA分级Ⅰ或Ⅱ级。采用随机数字表法，将其随机分为2组：Ⅰ组（n=38）和Ⅱ组（n=37）。依次静脉注射咪达唑仑2mg、异丙酚2mg／kg、舒芬太尼0．5μg/kg，睫毛反射消失后，Ⅰ组静脉注射罗库溴铵0．3mg／kg，2min后插入喉返神经监测专用气管导管；Ⅱ组吸入七氟醚，呼气末浓度达到4％时插入喉返神经监测专用气管导管。气管插管后行机械通气，吸入七氟醚维持麻醉。记录气管插管成功情况、气管插管条件的评分；采用神经肌电监测仪监测喉返神经诱发肌电位，于手术30min时每隔5min记录诱发肌电波振幅，直到手术70min；试验过程中监测SP、DP和HR。结果试验过程中DP、SP和HR均维持于正常范围。虽然2组气管插管一次成功率均为100％，但Ⅰ组气管插管条件优于Ⅱ组（P〈0．05）。尽管Ⅰ组喉返神经诱发的肌电位幅度低于Ⅱ组（P〈0．05），但肌电信号可满足监测要求。结论1倍ED95罗库溴铵用于甲状腺手术患者麻醉诱导不仅可提供满意的气管插管条件，且不影响术中喉返神经监测。Objective To investigate the effect of rocuronium 0.3 mg/kg （ED95） for anesthesia induction on monitoring of recurrent laryngeal nerve in patients undergoing thyroid surgery. Methods Seventy-five patients, ASA Ⅰ or Ⅱ , aged 20-70 yrR weighing 50-85 kg, scheduled for thyroid surgery, were randomly divided into two groups： rocuronium group （group Ⅰ , n = 38） and sevoflurane group （group Ⅱ, n = 37） . Anesthesia was in- duced with midazolam 2 mg, propofol 2 mg/kg, sulfentanil 0.5 μg/kg. After loss of eyelash reflex, group I re- ceived rocuronium 0.3 mg/kg （ED95） and was intubated with the electromyographie （EMG） endotracheal tube under glidescope at 2 min after rocuronium administration. Group Ⅱ received sevoflurane inhalation and was endotra- cheal intubated with EMG tube until end-tidal sevoflurane concentration achieved 4% . Anesthesia was maintained with inhalation of sevoflurane in both groups. SP, DP, and HR were monitored continuously through the surgery. Cooper＇s score and the success of attempt at endotracheal intubation were recorded. Recurrent laryngeal nerve evoked EMG was recorded by neuromonitoring and the amplitude of EMG responses was recorded at 5 rain intervals from 30 min to 70 min of surgery duration. Results SP, DP and HR remained within normal range in both groups. The success rates of endotracheal intubation were 100% in both groups, but the Cooper＇s score of group I was significantly higher than that of group Ⅱ （ P 〈 0.05） . Compared with group Ⅱ , the amplitude of EMG responses was significantly decreased in group Ⅰ （P 〈 0.05） . However, the EMG response in group Ⅰ was adequate for neuromonitoring of recurrent laryngeal nerve. Conclusion Rocuronium 0.3 mg/kg （ED95） for anesthesia induction can not only provide satisfied endotracheal intubation conditions, but also be adequate for monitoring of recurrent laryngeal nerve in patients undergoing thyroid surgery.

关 键 词：雄甾烷醇类 麻醉 全身 手术中并发症 

分 类 号：R614[医药卫生—麻醉学]