不同剂量米库氯铵在不同年龄儿童气管异物取出术麻醉中的应用  

Application of different doses of mivacurium for bronchial foreign body removal anesthesia in children with different ages

作　　者：史静 石磊[1] 王俊霞[1] 赵海涛[1] 包文娟[1] 容俊芳[2] SHI Jing;SHI Lei;WANG Jun-xia;ZHAO Hai-tao;BAO Wen-juan;RONG Jun-fang(Department of Anesthesiology,Affiliated Hebei Children′s Hospital of Hebei Medical University,Shijiazhuang 050031,China;Department of Anesthesiology,Hebei General Hospital,Shijiazhuang 050051,China)

机构地区：[1]河北医科大学附属河北省儿童医院麻醉科,河北石家庄050031 [2]河北省人民医院麻醉科,河北石家庄050051

出　　处：《河北医科大学学报》2019年第4期466-471,共6页Journal of Hebei Medical University

摘　　要：目的探讨不同剂量米库氯铵在不同年龄儿童气管异物取出术麻醉中的应用。方法选择拟行气管异物取出术儿童100例,依据其年龄和米库氯铵的诱导剂量随机分为4组各25例。Ⅰa、Ⅰb组(幼儿组,1～3岁)分别于麻醉诱导时静脉注射米库氯铵0.15 mg/kg、0.20 mg/kg;Ⅱa、Ⅱb组(年长儿组,>3～5岁)分别于麻醉诱导时静脉注射米库氯铵0.15 mg/kg,0.20 mg/kg。术中观察并记录肌松时效指标,包括起效时间,临床作用时间,RI、 TOFr75和TOFr90的时间。观察并记录置镜前后MAP、HR、SpO_2的变化,置镜满意率和不良反应的发生情况。结果不同剂量米库氯铵起效时间比较:与Ⅰa、Ⅱa组比较,Ⅰb、Ⅱb组ThD75、ThD90和ThDmax明显缩短,差异均有统计学意义(P<0.05)。不同年龄米库氯铵起效时间比较:与Ⅰa、Ⅱa组比较,Ⅱa、Ⅱb组ThDmax明显延长,差异有统计学意义(P<0.05)。各组临床作用时间, RI、TOFr 75、TOFr 90的时间差异均无统计学意义(P>0.05)。4组置镜满意率分别为96.0%、100.0%、88.0%和96.0%,其差异无统计学意义(P>0.05)。MAP、HR、SpO_2在组间、时点间、组间·时点间交互作用差异均无统计学意义(P>0.05)。4组颈前及胸前皮肤潮红发生率差异无统计学意义(P>0.05),4组均未发生血压下降和支气管痉挛。结论在应用同等剂量米库氯铵进行麻醉诱导时,幼儿的起效时间显著短于年长儿,但对肌松的恢复无影响;0.15 mg/kg米库氯铵即可为行气管异物取出术儿童提供满意的肌松效果。Objective To investigate application of different doses of mivacurium for bronchial foreign body removal in children with different ages.Methods One hundred children undergoing removing bronchial foreign body were enrolled.All the children were randomly divided into four groups according to their age and the initial dosage of mivacurium(n=25).Ⅰa and Ⅰb group(child group,1-3 years old):respectively intravenous injection of mivacurium 0.15 mg/kg and 0.20 mg/kg when induction of anesthesia;Ⅱa and Ⅱb group(older child group,3-5 years old):respectively intravenous injection of mivacurium 0.15 mg/kg and 0.20 mg/kg when induction of anesthesia.The muscle relaxation time index was observed and recorded which including the onset time,clinical duration,RI,TOFr75 and TOFr 90.MAP,HR and blood oxygen saturation were observed and recorded at the time of pre-inserting the bronchoscopy and after inserting the bronchoscopy.The mirror satisfaction rates,the operation time and occurrence of adverse reactions also were recorded.Results Compared with Ⅰa,Ⅱa group,there were significantly shortened inⅠb and Ⅱb group in ThDmax,ThD75 and ThD90(P<0.05).Comparison with groupⅠa,Ⅰb,the ThDmax was obviously prolonged inⅡa and Ⅱb group(P<0.05).There were no difference in the time of clinical action,RI,TOFr75 and TOFr90(P > 0.05).The satisfaction rates of the four groups were 96.0%,100.0%,88.0% and 96.0% in inserting mirror,respectively.There was no significant difference in the four groups(P > 0.05).There were no significant difference in MAP,HR and blood oxygen saturation before and after bronchoscope after injection of mivacurium chloride(P > 0.05).The incidence rate of skin flushing was no significant difference(P > 0.05).Low blood pressure and bronchospasm were not observed in the four groups.Conclusion It was found that the onset time for children was obviously shorter than that for the elder ones when the same doses of mivacurium were used during the anesthesia induction.While,there were not differences between th

关 键 词：气管 异物 米库氯铵 儿童 

分 类 号：R649.4[医药卫生—外科学]