琥珀胆碱导致术后肌痛发生的危险因素  

Risk factors for development of succinylcholine-induced postoperative myalgia

作　　者：徐振东[1] 高蕾[2] 李名伟[2] 车薛华[2] 

机构地区：[1]同济大学附属第一妇婴保健院麻醉科,上海市200040 [2]复旦大学附属华山医院麻醉科

出　　处：《中华麻醉学杂志》2015年第6期660-662,共3页Chinese Journal of Anesthesiology

基　　金：上海市卫生局基金面上项目（20124287）

摘　　要：目的筛选琥珀胆碱导致术后肌痛发生的危险因素。方法择期行头面部手术患者155例，年龄18～64岁，ASA分级Ⅰ或Ⅱ级，体重指数20～30kg／m^2。采用异丙酚全凭静脉麻醉或七氟醚静吸复合麻醉。根据术后24h内是否发生肌痛分为2组：肌痛组和非肌痛组。收集患者性别、年龄、体重、手术时间、麻醉方法、琥珀胆碱剂量、麻醉诱导时是否预先注射利多卡因和非去极化肌松药、术中是否使用激素（地塞米松或甲强龙）和非甾体类镇痛药（帕瑞昔布钠）以及芬太尼用量等。将组间差异有统计学意义的因素进行多因素logistic回归分析，筛选琥珀胆碱导致术后肌痛发生的危险因素。结果41例患者发生术后肌痛，发生率为27．2％。logistic回归分析结果显示：琥珀胆碱剂量〈1．5mg／kg和未预先注射利多卡因是琥珀胆碱导致患者术后肌痛发生的独立危险因素（P〈0．01）。结论琥珀胆碱剂量〈1．5mg／kg和未预先注射利多卡因是琥珀胆碱导致患者术后肌痛发生的独立危险因素。Objective To determine the risk factors for development of succinylcholine-induced postoperative myalgia. Methods One hundred and fifty-five patients, aged 18-64 yr, of ASA physical status Ⅰ or Ⅱ , with body mass index of 20-30 kg/m^2 , scheduled for elective eraniofacial surgery, were included in the study. Total intravenous anesthesia with propofol or combined intravenous-inhalational anesthesia with sevoflurane was performed during surgery. The patients were divided into 2 groups according to whether or not myalgia occurred within 24 h after surgery： myalgia group and non-myalgia group. Factors including gender, age, body weight, duration of surgery, method of anesthesia, dose of succinylcholine, preinjection of lidocaine or nondepolarizing muscular relaxants during induction of anesthesia, use of hormone （dexamethasone or methylprednisolone） and nonsteroidal analgesics （parecoxib sodium） during surgery, and consumption of fentanyl were recorded. The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify the risk factors for development of succinylcholine-induced postoperative myalgia. Results Forty-one patients developed postoperative myalgia, and the incidence of myalgia was 27.2%. The results of logistic analysis indicated that succinylcholine 〈 1.5 mg/kg and no preinjection of lidocaine were closely correlated with the development of postoperative myalgia induced by succinylcholine. Conclusion Succinylcholine〈1.5 mg/kg and no preinjectionof lidocaine are the risk factors for development of succinylcholine-induced postoperative myalgia in the patients.

关 键 词：琥珀酰胆碱 纤维肌痛 手术后并发症 危险因素 

分 类 号：R614[医药卫生—麻醉学]