米库氯铵应用于成人眼科手术的临床观察  

Clinical observation on mivacurium in adults undergoing ophthalmic surgery

作　　者：孔雪[1] 刘钢[1] 陈晓光[1] 

机构地区：[1]中国医科大学附属第一医院麻醉科,沈阳110001

出　　处：《实用药物与临床》2016年第6期706-708,共3页Practical Pharmacy and Clinical Remedies

基　　金：辽宁省科技厅面上项目(2013021082);沈阳市科委科技计划项目(F13-221-9-71)

摘　　要：目的观察不同剂量的米库氯铵及预注法给药应用于成人眼科手术中的临床效果。方法选择ASAⅠ～Ⅱ级,行眼科眶壁骨折修复术及眶内肿物摘除术的择期全麻患者60例,随机分为3组,每组20例,使用米库氯铵为全麻肌松药。A组：米库氯铵0.2 mg/kg组;B组：米库氯铵0.3 mg/kg组;C组：预注米库氯铵0.1 mg/kg,顺序给予其他全麻诱导药后,静注米库氯铵0.2 mg/kg。使用肌松监测仪进行肌松监测并记录药物起效时间、临床作用时间、完全恢复时间及恢复指数,并记录注药后各组出现的呛咳、屏气、体动、面部及前胸潮红和低血压等不良反应例数。结果 B组和C组起效时间明显短于A组,差异有统计学意义（P〈0.05）;B组和C组的临床作用时间及恢复指数与A组比较差异无统计学意义（P〉0.05）;B组的完全恢复时间较A组和C组延长,差异有统计学意义（P〈0.05）。各组均出现不良反应：A组9例,B组10例,C组3例。结论增加米库氯铵的诱导剂量可以缩短起效时间,获得良好的肌松效果,米库氯铵预注法不但能达到上述效果,且对苏醒时间几乎无影响,同时可以降低不良反应的发生率。Objective To observe the clinical effects of mivacurium of different doses and priming principle in adults undergoing ophthalmic surgery.Methods Sixty patients（ASA Ⅰ or Ⅱ） scheduled to undergo elective orbital fracture repair and orbit tumor excision surgery under general anesthesia（mivacurium as muscle relaxant） were randomly divided into 3 groups.Patients in group A（n=20） and group B（n=20） received 0.2 and 0.3 mg/kg mivacurium respectively,and group C（n=20） was given 0.2 mg/kg mivacurium after 0.1mg/kg mivacurium pre-injection.The muscle relaxation was monitored by TOF-Watch SX,and the onset time,clinical duration time,the complete recovery time and recovery index were recorded.The adverse effects including cough and bucking,bodymovement,skin flush and hypotension after administration were recorded.Results Compared with group A,the onset time of group B and group C were shortened obviously（P 〈0.05）;the duration time and recovery index were greater,but the results were not statistically significant（P〉0.05）.Compared with group A and group C,the complete recovery time of group B was significantly prolonged（P〈0.05）.Each group had adverse effects：9 cases in group A,10 cases in group B,3 cases in group C.Conclusion Increase the dosage of mivacurium can shorten onset time and obtained good effect of muscle relaxation;priming with small dose of mivacurium can also achieve the same effect and had no impact on awake time,and at the same time,reduced adverse effects.

关 键 词：米库氯铵 眼科手术 

分 类 号：R614[医药卫生—麻醉学]