不同倍数ED95顺式阿曲库铵配合吸入麻醉用于老年甲状腺术中喉返神经监测临床研究  

Clinical Study on ED95 Cis-Atracurium with Different Times Combined with Inhalation Anesthesia for Monitoring Recurrent Laryngeal Nerve During Thyroidectomy in Elderly Patients

作　　者：张秀果[1] 杜彦茹[1] 韩霜[1] 蔚冬冬 段然 吴亚敬 ZHANG Xiuguo;DU Yanru;HAN Shuang;YU Dongdong;DUAN Ran;WU Yajing(Department of Anesthesiology,Hebei General Hospital,Shijiazhuang,Hebei,China 050051)

机构地区：[1]河北省人民医院麻醉科

出　　处：《中国药业》2019年第11期68-70,共3页China Pharmaceuticals

基　　金：河北省科技计划项目[15277729D]

摘　　要：目的探讨不同倍数ED95顺式阿曲库铵配合吸入麻醉在老年甲状腺术中喉返神经监测中的运用效果。方法选取医院2017年8月至2018年5月收治的择期行老年甲状腺手术患者63例,回顾性分析临床资料,按顺式阿曲库铵诱导剂的使用量,将63例患者分为1倍ED95组、2倍ED95组、3倍ED95组,各21例。5 min后,采用可视喉镜插入喉返神经监测用气管导管行机械通气,术中吸入七氟醚维持麻醉。结果插管30s后,3组患者收缩压(SBP)、舒张压(DBP)、心率(HR)均较插管前明显升高(P<0.05),且2倍ED95组、3倍ED95组均明显低于1倍ED95组(P<0.05),但2倍ED95组、3倍ED95组组间比较无显著差异(P>0.05);3组患者插管时喉镜暴露Cormach-Lehane(C-L)分级均为Ⅰ级和Ⅱ级,组间比较,2倍ED95组、3倍ED95组插管时,Ⅰ级比例明显高于1倍ED95组,Ⅱ级比例明显低于1倍ED95组(P<0.05);1倍ED95组插管时,3例患者出现呛咳反应,发生率明显高于其他组(P<0.05);3组患者刺激侧电信号的波峰值随时间推移而升高(P<0.05),与1倍ED95组和2倍ED95组比较,3倍ED95组给药后40 min(T1)时无电信号,在给药后50 min(T2)、给药后60 min(T3)时电信号波峰值明显较低(P<0.05);1倍ED95组、2倍ED95组各时间点电信号波峰值比较无明显差异(P>0.05)。结论2倍ED95顺式阿曲库铵配合吸入麻醉用于老年甲状腺术,不仅有助于提供满意的气管插管条件,而且对术中喉返神经监测无明显影响,可作为该类手术麻醉诱导的适宜剂量。Objective To investigate the application of ED95 cis-atracurium with different times combined with inhalation anesthesia for monitoring recurrent laryngeal nerve during thyroidectomy in elderly patients.Methods Totally 63 elderly patients underwent thyroidectomy admitted to our hospital from August 2017 to May 2018 were selected,the clinical data of all patients were analyzed by retrospective analysis.The 63 patients were divided into 1 time ED95 group,2 times ED95 group,3 times ED95 group according to the dosage of cis-atracurium,21 cases in each group.After 5 min,glidescope was used to insert the recurrent laryngeal nerve to monitor,mechanical ventilation was performed with tracheal catheter,and intraoperative sevoflurane was used to maintain anesthesia.Results After30 s of intubation,the systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)in the three groups were significantly higher than those before intubation(P<0.05),and those in the 2 times ED95 group and 3 times ED95 group were significantly lower than those in the 1 time ED95 group(P<0.05),but there was no significant difference between the 2 times ED95 group and 3 times ED95 group(P>0.05).At intubation,the Cormach-Lehane(C-L)grading of the three groups were all gradeⅠandⅡ.Compared with 1 time ED95 group,the proportion of C-L gradeⅠin the 2 times ED95 group and 3 times ED95 group was significantly higher,while the proportion of C-L gradeⅡin the 2 times ED95 group and 3 times ED95 group was significantly lower(P<0.05).3 patients in 1 time ED95 group had cough response during intubation,and the incidence rate was significantly higher than that in the other two groups(P<0.05).The peak values of the electrical signals on the stimulation side of the 3 groups increased with time(P<0.05).Compared with 1 time ED95 group and 2 times ED95 group,there was no electric signal at 40 min(T1)after administration in the 3 times ED95 group,while the peak values of electric signal at 50 min(T2)and 60 min(T3)after administration were signific

关 键 词：甲状腺术 顺式阿曲库铵 七氟醚 ED95 术中喉返神经监测 

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