米库氯胺在小儿扁桃体摘除术中的应用  

Application of mivacurium chloride in pediatric tonsillectomy

作　　者：周文涛[1] 王芳茹[1] ZHOU Wen-tao;WANG Fang-ru(Department of Anesthesiology,the Second People＇s Hospital of Shaanxi,Xi＇an,Shaanxi 710005,China)

机构地区：[1]陕西省第二人民医院麻醉科,陕西西安710005

出　　处：《中国临床研究》2018年第11期1535-1537,共3页Chinese Journal of Clinical Research

基　　金：陕西省科技厅2016年社会发展科技攻关科研项目(2016-21)

摘　　要：目的观察单次静脉注射米库氯胺在小儿扁桃体摘除术中的应用及临床效果。方法选择2016年3月至2017年5月美国麻醉医师协会(ASA)分级法Ⅰ～Ⅱ级的择期扁桃体摘除术患儿150例,按照就诊先后顺序分为两组:A组(米库氯胺+瑞芬太尼组,n=75)和B组(罗库溴铵+瑞芬太尼组,n=75),观察两组患儿入室、麻醉诱导后、术中、手术结束、拔除气管插管时和拔管后5 min各时间点心率(HR)、收缩压(SBP)、舒张压(DBP)的变化,比较停药后呼之睁眼时间、拔管时间、离开术后恢复室(PACU)时间,记录术后24 h恶心、呕吐、睡眠、咽部不适情况。结果两组患儿各时间点的HR、SBP、DBP比较差异无统计学意义(P> 0. 05);A组患者呼之睁眼时间[(5. 76±2. 91) min vs (10. 37±4. 31) min]、拔管时间[(6. 20±5. 66) min vs (12. 01±6. 38) min]、离开PACU时间[(25. 43±3. 21) min vs (32. 96±4. 66) min]均短于B组,差异有统计学意义(P <0. 01);两组术后24 h均未见明显躁动、恶心、呕吐、睡眠障碍、手术部位不适等不良反应。结论米库氯胺联合瑞芬太尼应用于小儿扁桃体摘除术中效果确切,自主呼吸恢复较快,麻醉苏醒时间短,较适合应用于小儿扁桃体摘除术的麻醉。Objective To observe the effect of single intravenous injection of mivacurium chloride in pediatric tonsillectomy. Methods A total of 150 children scheduled to undergo tonsillectomy with American society anesthesiologists（ASA）-Ⅱ grade were selected and divided into group A（mivacurium chloride plus remifentanil） and group B（rocuronium bromide plus remifentanil） according to the order of visits. Between two groups,the changes of heart rate（HR） and systolic blood pressure（SBP） and diastolic blood pressure（DBP） at the time of admission,anesthesia induction,intraoperative,end of surgery,removal of tracheal intubation,and 5 min after extubation were observed;the time of calling-open eyes,extubation and leaving the postanesthesia care unit（PACU） were compared; the incidences of nausea,vomiting,sleep and throat discomfort during 24-hour postoperative follow-up were recorded. Results There were no significant differences in HR,SBP and DBP at each time point between two groups（all P〉0. 05）. The time of calling-open eyes[（5. 76 ± 2. 91） min vs（10. 37 ± 4. 31） min],time of extubation [（6. 20 ± 5. 66） min vs（12. 01 ± 6. 38） min] and time of leaving PACU[（25. 43 ± 3. 21）min vs（32. 96 ± 4. 66）min]in group A were significantly shorter than those in group B（all P〈0. 01）.No significant adverse reactions such as restlessness,nausea,vomiting,sleep disturbance and discomfort of operation site were observed during postoperative 24 hours in both two groups. Conclusions Mivacurium chloride combined with remifentanil for tonsillectomy in children has a definite effect with rapid recovery of spontaneous breathing,short recovery time after anesthesia. It is more suitable for anesthesia of pediatric tonsillectomy.

关 键 词：米库氯胺 扁桃体摘除术 小儿 瑞芬太尼 麻醉效果 

分 类 号：R726.1[医药卫生—儿科]