米库氯铵用于全麻手术40例的临床分析  

Mivacurium for General Anesthesia: a Clinical Analysis of Forty Cases

作　　者：肖海峰[1] 张振[1] 田丽颖[1] 孙美艳[1] 高佳栋[1] 高昌俊[1] 赵晖[1] 孙绪德[1] 

机构地区：[1]第四军医大学唐都医院麻醉科,陕西西安710038

出　　处：《现代生物医学进展》2016年第9期1667-1670,共4页Progress in Modern Biomedicine

基　　金：陕西省社会发展攻关项目(2014k11-02-01-14);唐都医院科技创新发展基金项目(2014JSYL003)

摘　　要：目的：观察米库氯铵分别复合七氟醚、丙泊酚用于全麻手术的肌松效果和安全性,以及对米库氯铵剂量的影响。方法：选择妇科手术患者40例,随机分为七氟醚组和丙泊酚组。诱导期单次静注米库氯铵,肌松开始恢复时开始泵注,手术结束前约20 min停药。记录诱导起效时间、无反应期,停止泵注米库氯铵后TOF比值恢复至25%、50%、75%、90%时间、恢复指数,维持期米库氯铵平均泵注速度、平均追加次数。结果：S组有2例、P组有1例出现轻度皮肤潮红,P组有1例插管时出现轻度呛咳,血压、心率未见明显异常,插管条件均满意。两组诱导起效时间、无反应期、恢复指数无统计学差异,停药后TOF比值恢复至25%、50%、75%、90%时间S组长于P组,差异有统计学意义。S组维持期米库氯铵平均泵注速度、平均追加次数小于P组,差异有统计学意义。结论：米库氯铵用于全麻诱导及维持,肌松满意,恢复迅速,安全性值得肯定。与丙泊酚相比,七氟醚对米库氯铵的需要量大约可以减少20%～30%,丙泊酚对米库氯铵剂量的具体影响有待进一步研究。Objective： To investigate the neuromuscular blockade, safety and requirements of mivacurium for general anesthesia,while sevoflurane and propofol were used. Methods： Forty patients scheduled for gynecological surgery were randomly divided into sevoflurane group（group S, n=20） and propofol group（group P, n=20）. The mivacurium was injected singly during the induction period,and resume to inject at the beginning of muscle relaxation recovery, and stop to pump about 20 min before the end of surgery. The onset time, no response period, recovery time of TOFr（25 %, 50 %, 75 %, 90 %）, recovery index, average infusion rate, and average additional times were recorded. Results： There are two cases and one case with mild skin flushing in group S and group P respectively. One patient had mild cough without obvious abnormalities of blood pressure and heart rate in group P. The intubation conditions were all satisfied in both groups. The onset time of induction, no response period and recovery index have no differences in two groups（P〈0.05）. After stop pumping mivacurium, the recovery time of 25 %, 50 %, 75 %, 90 % are significantly longer in group S than group P（P〈0.05）. The average infusion rate and additional times of mivacurium were lower in group S than group P during the maintaining period（P〈0.05）. Conclusions：The neuromuscular blockade, rapid recovery and security should be affirmed when mivacurium was used for general anesthesia. Sevoflurane compared with propofol, the requirement of mivacurium can be reduced from about 20 % to 30 %, the specific effects of propofol on mivacurium dose need to be studied further.

关 键 词：米库氯铵 七氟醚 丙泊酚 肌松监测 四个成串刺激(TOF) 

分 类 号：R614.1[医药卫生—麻醉学]