琥珀胆碱与罗库溴铵在剖宫产术全麻诱导中的应用比较  

Comparison of scoline and rocuronium in pregnant women receiving cesarean section under general anesthesia

作　　者：汪涛[1] 张望平[2] 

机构地区：[1]嘉兴市武警浙江省总队医院麻醉科,浙江嘉兴314000 [2]嘉兴市妇幼保健院麻醉科,浙江嘉兴314000

出　　处：《实用药物与临床》2016年第9期1132-1134,共3页Practical Pharmacy and Clinical Remedies

基　　金：浙江省医学会临床科研基金(2015ZYC-71A)

摘　　要：目的比较罗库溴铵和琥珀胆碱在剖宫产术全麻中的效果。方法选择拟全麻下行剖宫产术孕妇60例,采用随机数字表法分为用罗库溴铵组(L组)、琥珀胆碱组(S组),每组30例,采用芬太尼2μg/kg、丙泊酚2 mg/kg、罗库溴铵0.6 mg/kg或琥珀胆碱1.5 mg/kg诱导后气管插管(插管前1 min静注艾司洛尔30 mg)。比较两组麻醉前(T_0)、插管时(T_1)、插管后5 min(T_2)及关腹(T_3)时的血压和心率情况,记录两组肌松药的起效时间,新生儿行Apgar评分和脐动脉血气分析,观察其并发症。结果 S组起效时间较L组缩短[(78.6±10.6)s vs.(87.4±16.7)s](P<0.05),但L组气管插管条件优良,几乎无不良反应。两组气管插管前后血压、心率比较差异无统计学意义(P>0.05)。两组新生儿Apgar评分和脐动脉血气分析比较差异无统计学意义(P>0.05)。结论在剖宫产全麻中罗库溴铵起效时间比琥珀胆碱长,但气管插管条件优于琥珀胆碱,且不良反应少,是目前剖宫产全身麻醉的良好的肌松药。Objective To compare the effects of scoline and rocuronium on pregnant women receiving cesarean section under general anesthesia. Methods Sixty parturients scheduled for elective caesarean section under general anesthesia were randomly divided into group S and group L （ n = 30 ）. Anesthesia was induced with rocuronium 0. 6 mg/kg in group L and scoline 1.5 mg/kg in group S. The blood pressure and heart rate of the two groups before anes- thesia （ To ） , at the time of intubation （ T1 ） , at 5 min after intubation （ T2 ） and at the time of closing abdomen （ T3 ） were compared. The onset time was recorded, and the Apgar score and blood gas analysis of umbilical artery blood were performed. The side effects were observed. Results The effective time of group S was significantly shorter than that of group L[ （ 78.6± 10. 6 ） s vs. （ 87.4 ± 16. 7 ） s ] （ P 〈 0. 05 ） , but group L had excellent tracheal intubation conditions without adverse reaction. No significant difference was found in blood pressure and heart rate between the two groups （ P 〉 0. 05 ）. Moreover, Apgar scores and blood gas analysis of umbilical artery blood showed no significant difference between the two groups （ P 〉 0. 05 ）. Conclusion Both rocuronium and scoline are good muscle relaxants in elective cesarean section under general anesthesia. Rocuronium is more suitable for cesarean delivery during anesthesia induction for the good condition of intubation and fewer side effects.

关 键 词：琥珀胆碱 罗库溴铵 剖宫产 全身麻醉 

分 类 号：R614.2[医药卫生—麻醉学]