罗库溴铵联合预给氧无正压通气在急诊饱胃脑外伤患者全麻中的应用  

The application of Rocuronium bromide combined with no ventilation during rapid sequence induction of anesthesia in full stomach patients

作　　者：肖金辉[1] 彭明 林萍[1] 吴建航 刘荣[1] 

机构地区：[1]解放军第184医院麻醉科,江西鹰潭335000

出　　处：《中国实验诊断学》2017年第10期1750-1752,共3页Chinese Journal of Laboratory Diagnosis

摘　　要：目的观察罗库溴铵联合预给氧无正压通气快速诱导在急诊脑外伤饱胃患者气管插管的可行性和安全性。方法 60例需急诊行颅内血肿清除术的脑外伤饱胃患者随机分为3组,每组20例。麻醉前保持自主呼吸,面罩吸入纯氧5min后静脉注入咪唑安定、舒芬太尼、异丙酚,A组不用肌松药,保留自主呼吸气管插管;S组追加琥珀胆碱1.5mg/kg,R组追加罗库溴铵0.9mg/kg,60s后行气管插管,三组患者诱导期间均不实施正压辅助通气。观察并记录诱导前后各时间点SpO_2、HR、MAP的变化情况、插管评分以及不良反应。结果 (1)三组患者在诱导期间SpO_2均能维持在96%以上,但T3、T4时间点A组HR、MAP明显高于S组和R组(P<0.05)。(2)A组插管评分明显低于S组和R组(P<0.05)。(3)诱导期间R组呛咳、呕吐、返流等不良反应的总发生率明显低于A组(P<0.05),但S组有3例患者出现返流,1例呕吐,1例误吸。结论罗库溴铵联合预给氧无正压通气技术用于急诊脑外伤饱胃患者快速诱导,操作性强、安全可靠、并发症少。Objective To investigate the safety and the feasibility of applying Rocuronium bromidecombined with noventilation during rapid sequence induction of anesthesia in full stomach patients.Methods 60full-stomachpatientsundergoinggeneralanesthesia and emergency operation,were randomly devided into three groups with 20 cases each.Inhaled 100% oxygen via face mask for 5min withoutpositivepressure ventilation before induction of anesthesia.Group A were performed intravenous injection with sufentanyl,midazolam,propofol without muscle relaxant（remaining spontaneouslybreathing）before intubation,rocuronimn 0.9 mg/kg（R group）and succinylcholine 1.5 mg/kg（S group）were given by intravenous.Tracheal intubation was given 60 seconds after injection.SpO2、HR、MAPwere recorded at each point in time,Intubation score and complications of induction were recorded.Results HR and MAP of group A was significantly higher than that of the group S and group Rat T3,T4（P〈0.05）.The intubation score of group A was significantly lower than that of the group S and group R（P〈0.05）.The prevalence of side effects in group R was significantly lower than that in groups AS（P〈0.05）.In group S,3patientsshowedregurgitation,1patientshowedaspiration,1patientshowed emesis.Conclusion The technique of applying rocuronium with no ventilation during rapid sequence induction of anesthesia on the full stomach patients is safe and feasible.

关 键 词：罗库溴铵 无正压通气 饱胃 快速诱导 

分 类 号：R614[医药卫生—麻醉学]