小剂量司可林复合瑞芬太尼用于支撑喉镜下喉显微手术的效果分析  

The effects of a low dose of succinylcholine in combination with remifentanil for suspension microlaryngoscopy

作　　者：伍金红[1] 周晓洁[1] 贾继娥[1] 

机构地区：[1]复旦大学附属眼耳鼻喉科医院麻醉科,上海200031

出　　处：《复旦学报（医学版）》2016年第3期313-317,共5页Fudan University Journal of Medical Sciences

摘　　要：目的评估小剂量司可林复合瑞芬太尼用于显微喉镜的有效性及优越性。方法选择年龄18~60岁,ASAⅠ~Ⅱ级,2015年1至5月择期行支撑喉镜下喉显微手术患者167例。随机分为3组：司可林0.6 mg/kg组（A组）,司可林1 mg/kg组（B组）,司可林0.6 mg/kg复合瑞芬太尼1.5μg/kg组（R组）。采集患者基础、诱导后、插管后即刻、悬吊喉镜后即刻和拔管后即刻的心率、血压;记录诱导后肌颤、声门开放情况、术中是否需要追加肌松药、术后肌痛和手术时间等,并进行统计分析。结果 3组患者均顺利地实施了气管插管、悬吊支撑喉镜等操作,且3组患者在肌颤、声门开放、追加肌松药、术后肌痛和手术时间等方面无明显差异。循环方面表现为：R组患者诱导后、插管后、悬吊支撑喉镜及拔管后心率和血压的波动明显小于A组（P〈0.05）;R组在诱导后的血压和悬吊喉镜后的心率波动明显小于B组（P〈0.05）。结论小剂量司可林复合瑞芬太尼能够很好地用于支撑喉镜下喉显微手术,且循环波动小,对肌颤及术后肌痛无影响。Objective To evaluate the effects and superiority of a low dose of succinylcholine in combination with remifentanil for suspension microlaryngoscopy. Methods A total of 167 patients of18-60 years old and ASAⅠ-Ⅱ undergoing selective suspension microlaryngoscopy from Jan.to May in 2015 were enrolled.The patients were randomly divided into 3 groups：succinylcholine 0.6 mg/kg group（group A）,succinylcholine 1 mg/kg group（group B）,succinylcholine 0.6 mg/kg in combination with remifentanil 1.5μg/kg group（group R）.Heart rate and blood pressure were collected at the time points of before and after induction,after tracheal intubation,suspensing laryngoscope and after extubation.Muscle fasciculation during induction,vocal cords opening levels,succinylcholine added or not during the operation,postoperative myalgia and operation time were recorded.All the data were analyzed by statistical software. Results All the 3 groups of patients were successfully undertaken trachea ntubation and suspension laryngoscope.There was no significance in muscle fasciculation,vocal cords opening levels,succinylcholine added during the operation,postoperative myalgia and operation time.On circulatory performance,fluctuation of heart rate and blood pressure in the patients in group R was less than group A（P〈0.05）at the time points of after induction,after intubation,suspension laryngoscope and extubation,and also less than group B after induction（P〈0.05）. Conclusions A low dose of succinylcholine in combination with remifentanil was effective in suspension microlaryngoscopy and superiority in stablity of circulation without muscle fasciculation and postoperative myalgia.

关 键 词：司可林 瑞芬太尼 显微喉镜 肌颤 术后肌痛 

分 类 号：R762[医药卫生—耳鼻咽喉科]