顺式阿曲库铵复合丙泊酚对全身麻醉患者应激反应及肌松效应的影响  

Effect of Cisatracurium Combined with Propofol on Stress Response and Neuromuscular Blocking Effect in Patients Undergoing General Anesthesia

作　　者：曹丽燕 纪金芬 王丽梅 Cao Liyan;Ji Jinfen;Wang Limei(Department of Anesthesiology,Zhangjiagang Hospital of Traditional Chinese Medicine,Zhangjiagang,Jiangsu,China 215600)

机构地区：[1]江苏省张家港市中医医院麻醉科,江苏张家港215600

出　　处：《中国药业》2018年第20期25-27,共3页China Pharmaceuticals

基　　金：江苏省中医药局科技项目[LZ13153]

摘　　要：目的探讨顺式阿曲库铵复合丙泊酚对全身麻醉患者应激反应及肌松效应的影响。方法选取医院2015年9月至2018年1月全身麻醉手术患者81例,随机分为复合麻醉组(45例)和常规麻醉组(36例)。两组患者均采用丙泊酚和瑞芬太尼静脉靶控麻醉,复合麻醉组在此基础上给予顺式阿曲库铵麻醉治疗。应用Cooper评分法评估患者的插管条件,并采用4个成串刺激(TOF)进行肌松监测,分析两组不同时间点[麻醉前(T_0)、插管时(T_1)、切片时(T_2)、拔管时(T_3)]的平均动脉压(MAP)、心率(HR)、围拔管期肌松恢复指数及麻醉学相关不良反应等指标。结果复合麻醉组患者插管条件明显优于常规麻醉组(P <0. 05);随着麻醉的不断推进,复合麻醉组MAP和HR水平波动不明显(P> 0. 05),而常规麻醉组MAP和HR水平变化明显(P <0. 05),且T_1,T_2,T_3时,复合麻醉组MAP和HR水平均明显低于常规麻醉组(P <0. 05);复合麻醉组患者肌松恢复指数明显高于常规麻醉组(P <0. 05);两组不良反应发生率相当(6. 67%比5. 56%,P> 0. 05)。结论顺式阿曲库铵复合丙泊酚可有效改善全身麻醉患者的插管条件,降低手术中机体的应激反应,维持血流动力学稳定,安全性较高。Objective To investigate the effect of cisatracurium combined propofol on stress response and neuromuscular blocking effect in patients undergoing general anesthesia. Methods Totally 81 patients undergoing general anesthesia in our hospital from September2015 to January 2018 were selected and randomly divided into the combined anesthesia group（ n = 45） and routine anesthesia group（ n = 36）. The two groups were given intravenous target-controlled anesthesia with propofol and remifentanil,on this basis,the combined anesthesia group was given cisatracurium for anesthesia treatment. Cooper scoring was used to assess the intubation conditions and train of four stimulation（ TOF） were used for neuromuscular monitoring. The mean arterial pressure（ MAP）,heart rate（ HR）,recovery index of muscle relaxation during peri-extubation period and related anesthetic adverse reactions and other indicators at different time points[ pre-anesthesia（ T0）,intubation time（ T1）,sectioning time（ T2）,extubation time（ T3） ] were analyzed. Results The intubation condition of patients in the combined anesthesia group was significantly better than that in the routine anesthesia group（ P〈0. 05）. With the continuous progress of anesthesia,the levels of MAP and HR in the combined anesthesia group did not fluctuate significantly（ P〉0. 05）,while the levels of MAP and HR in the routine anesthesia group changed significantly（ P〈0. 05）,and the levels of MAP and HR in the combined anesthesia group at the time of T1,T2,T3 were significantly lower than those in the routine anesthesia group（ P〈0. 05）.The recovery index of muscle relaxation in the combined anesthesia group was significantly higher than that in the routine anesthesia group（ P〈0. 05）. The incidence rates of adverse reactions in the two groups were similar（ 6. 67 % vs. 5. 56 %,P〉0. 05）.Conclusion Cisatracurium combined with propofol can effectively improve the intubation condition of patients undergoing general anesthesia,r

关 键 词：全身麻醉 顺式阿曲库铵 丙泊酚 应激反应 肌松效应 

分 类 号：R969.4[医药卫生—药理学] R971.2[医药卫生—药学]