琥珀胆碱与罗库溴铵用于股骨头置换术患者喉罩麻醉的对照研究  

Contrastive study on application of succinylcholine and rocuronium in laryngeal mask anesthesia for patients with femoral head replacement

作　　者：李敏仙[1] 顾颖红[1] 

机构地区：[1]海南医学院附属医院麻醉科,海南海口570102

出　　处：《重庆医学》2016年第6期763-766,共4页Chongqing medicine

基　　金：海南省卫生厅课题资助项目(琼卫2011-45)

摘　　要：目的探讨喉罩辅助肌肉松弛药对股骨头置换术患者麻醉诱导期应激反应的影响。方法将股骨头置换术全身麻醉患者180例根据随机数字表法分为观察组与对照组各90例,对照组推注琥珀胆碱1.5mg/kg进行麻醉诱导,观察组推注罗库溴铵0.8mg/kg进行麻醉诱导,两组患者均放置SLIPA喉罩进行辅助麻醉。记录患者诱导前(T0)、置入喉罩前(T1)、置入喉罩后1min(T2)、拔除喉罩前3min(T3)、拔除喉罩后3min(T4)的中心动脉压(MPA)及心率(HR)的变化;检测血浆皮质醇、血管紧张素Ⅱ及血糖水平;并于术毕6、24、48h以视觉模拟评分(VAS)进行疼痛评分比较。结果与T0相比,T1时间点两组患者的MAP与HR降低(P<0.05);观察组T2、T3、T4时间点的MAP、HR与T0比较,差异无统计学意义(P>0.05);对照组T2、T3、T4时间点的MAP、HR明显升高,在组内与组间比较差异均有统计学意义(P<0.05)。观察组不同时间点的血浆皮质醇和血管紧张素Ⅱ比较差异无统计学意义(P>0.05),而对照组的血浆皮质醇和血管紧张素Ⅱ值在T2时呈现明显增加的趋势(P<0.05)。两组不同时间点的血糖水平比较,差异无统计学意义(P>0.05)。观察组术毕6、24、48h的疼痛VAS评分均明显低于对照组(P<0.05)。结论喉罩辅助肌肉松弛药罗库溴铵在股骨头置换术患者麻醉中的应用能缓解麻醉诱导期的应激反应,减轻交感和副交感神经的兴奋。Objective To investigate the influence of laryngeal mask auxiliary muscle relaxant drug on the stress response effects during anesthesia induction period for the patients with femoral head replacement.Methods A total of 180 cases of femoral head replacement under general anesthesia were equally divided into the treatment group and the control group according to the random number table,90 cases in each group.The control group was intravenously injected by succinylcholine 1.5mg/kg for conducting the anesthesia induction,while the treatment group was intravenously injected by rocuronium 0.8mg/kg for anesthesia induction.The two groups were placed the SLIPA laryngeal mask for conducting the assisted anesthesia.The changes of central arterial pressure（MPA）,heart rate（HR）,plasma cortisol,angiotensinⅡ and blood sugar levels in the two groups were detected and recorded before induction（T0）,before laryngeal mask insertion（T1）,at 1min after laryngeal mask insertion（T2）,at 3min before laryngeal mask removal（T3）and at 3min after laryngeal mask removal（T4）;the pain VAS scores at postoperative 6,24,48 hwere compared between the two groups.Results Compared with T0,the MAP and HR values at T1 in the two groups were decreased significantly（P0.05）;the MAP and HR values at T2,T3,T4 in the treatment group had no statistical differences compared with those at T0（P0.05）;while which in the control group were significantly increased,the differences between the intra-group groups and inter-group were statistically significant（P0.05）.The plasma cortisol and angiotensin Ⅱ values in the treatment group had no statistically significant differences among different time points,while which at T2 in the control group showed the significantly increasing trend,difference was statistically significant（P0.05）.The blood glucose levels at different time points had no statistically significant differences between the two groups（P0.05）.The pain VAS scores at postoperative 6,24,48 hin the treatment grou

关 键 词：喉罩 罗库溴铵 股骨头置换术 麻醉诱导期 应激反应 

分 类 号：R614[医药卫生—麻醉学]