肌松药对微血管减压术术中神经电生理监测和气管插管的影响  

The effect of muscle relaxant on electrophysiological monitoring and endotracheal intubation in microvascular decompression

作　　者：申珍 代志刚[1] 王胜[1] 邵秀芝[1] 张圆圆[2] 张振英[3] 

机构地区：[1]新疆石河子大学医学院第一附属医院麻醉科,新疆石河子832000 [2]苏州大学医学中心麻醉科 [3]上海市徐汇区中心医院麻醉科

出　　处：《中国现代医药杂志》2017年第11期6-9,共4页Modern Medicine Journal of China

摘　　要：目的探讨肌松药对行微血管减压术(Microvascular decompression,MVD)患者术中神经电生理监测(Intraoperative neurophysiological monitoring,IONM)及气管插管的影响。方法选择2015年10月?2017年6月拟行MVD术患者60例,根据所使用肌松药的不同随机分为氯化琥珀胆碱组(SCH组,n=20)、苯磺酸顺阿曲库铵组(CIS组,n=20)和对照组(不使用肌松药,n=20),对比分析3组患者电生理波形诱导成功率、气管插管条件和血流动力学变化。结果在手术开始前,对照组和SCH组电生理波形诱导成功率为100.0%,明显高于CIS组的75.0%(P<0.05)。SCH组插管条件优秀率为100.0%,虽高于CIS组(90.0%)和对照组(85.0%),但差异无统计学意义(P>0.05)。3组患者气管插管前和气管插管后的HR和MAP比较,差异无统计学意义(P>0.05)。结论 MVD术麻醉诱导时使用非去极化肌松药会延长电生理波形引出时间,在行电生理监测的MVD术麻醉诱导时尽量不使用非去极化肌松药。Objective To determine the effects of muscle relaxant on intraoperative neurophysiological monitoring（IONM） and endotracheal intubation in microvascular decompression（MVD）. Methods Sixty cases of patients undergoing MVD were selected from Oct 2015 to Jun 2017. According to the different muscle relaxant,the patients were divided into Succinylcholine chloride group（SCH group,n=20）,the Cisatracurium besilatet group（CIS group,n=20） and the control group（non-muscle relaxant,n=20）. Results Before the operation,the success rate of electrophysiological waveform induction of the control group and the SCH group were 100.0%,obviously higher than that of the CIS group（75.0%）, P0.05. The excellent rate of the intubation was 100.0% in SCH group,higher than the CIS group（90.0%） and the control group（85.0%）,but the difference was not statistically significant（P0.05）. There was no significant difference among the three groups in HR and MAP before and after endotracheal intubation（P0.05）. Conclusion The non depolarizing muscle relaxant can prolong the time of electrophysiological waveform extraction,so it should not be used in anesthesia induction of MVD surgery with neurophysiological monitoring.

关 键 词：肌松药 微血管减压术 术中神经电生理监测 气管插管 

分 类 号：R614[医药卫生—麻醉学]