琥珀胆碱对气管插管后高位颈内静脉血氧饱和度的影响  

Effect of succinylcholine on blood oxygen saturation of upper internal jugular vein after tracheal intubation

作　　者：晋维林[1] 费建平[1] 赵赢 雷月[1] 王欢锋[1] 包华芳[1] 袁春英[1] Jin Weilin;Fei Jianping;Zhao Ying;Lei Yue;Wang Huanfeng;Bao Huafang;Yuan Chunying(Department of Amesthe-Siology,Kunshan Traditional Chinese Medicine Hospital,Jiangsu 215300,China)

机构地区：[1]江苏省昆山市中医医院麻醉科,215300

出　　处：《中国药物与临床》2021年第19期3228-3231,共4页Chinese Remedies & Clinics

基　　金：江苏省昆山市社会发展科技计划(KS1954)。

摘　　要：目的探讨注射琥珀胆碱后肌梭震颤对气管插管全身麻醉患者脑血流及脑氧耗的影响。方法将65例患者采用数字表法随机分配进入试验组(S组,33例)和对照组(D组,32例),在气管插管前分别注射氯化琥珀胆碱1.3 mg/kg和顺苯磺酸阿曲库铵0.3 mg/kg。在入室后(T_(0))、气管插管后3 min(T_(1))、10 min(T_(2))、20 min(T_(3))以及手术开始后20 min(T_(4))、术毕拔管后10 min(T_(5))超声引导下下颌角平面颈内静脉穿刺采集血液进行血气分析,对比高位颈内静脉血氧分压(upPvO_(2))、高位颈内静脉血氧饱和度(upSvO_(2))、高位颈内静脉血二氧化碳分压(upPvCO_(2))以及高位颈内静脉血乳酸(upvBLac)和血糖(upvGlu)改变。结果T_(0)~T_(5)时upPvO_(2)、upSvO_(2)、upPvCO_(2)、upvBLac和upvGlu组间比较差异均无统计学意义(P>0.05);与T_(0)比较,两组患者T_(1)~T_(5)时upPvO_(2)、upSvO_(2)、upPvCO_(2)升高,差异有统计学意义(P<0.01);与T_(1)比较,T_(2)时2组患者upPvO_(2)、upSvO_(2)均下降,其中D组upSvO_(2)下降差异有统计学意义(P<0.05)。T_(0)~T_(5)2组患者upvBLac均持续下降,与T_(0)比较,S组T_(4)~T_(5)和D组T_(3)~T_(5)时upvBLac下降,差异有统计学意义(P<0.05);与T_(0)比较,T_(1)~T_(3)时2组患者upvGlu改变,差异无统计学意义(P>0.05)。结论注射琥珀胆碱对气管插管后高位颈内静脉血氧饱和度的影响极其微弱。合理选择静脉麻醉药,通过设计麻醉诱导用药程序,可以避免气管插管后脑组织过度灌注和脑氧代谢的增加。Objective To investigate the impact of muscle spindle tremor after succinylcholine injection on cerebral blood flow and oxygen consumption in patients tracheally intubated for general anesthesia.Methods Sixty-five patients were assigned to the study group(group S,n=33)or the control group(group D,n=32)using the random number table,to be injected with 1.3 mg/kg succinylcholine or 0.3 mg/kg cisatracuriumbesylate,respectively,prior to tracheal intubation.At entering the operation room(T_(0)),3min(T_(1)),10min(T_(2))and 20min(T_(3))after tracheal intubation,at 20min(T_(4))of the operation,and at 10min after postoperative extubation(T_(5)),blood samples were collected by phlebotomy of the internal jugular vein at the mandibular plane under ultrasound guidance,and subjected to blood gas analysis.The two groups were compared for upper internal jugular venous oxygen partial pressure(upPvO_(2)),upper internal jugular venous oxygen saturation(upSvO_(2)),upper internal jugular venous carbon dioxide partial pressure(upPvCO_(2)),and upper internal jugular venous lactic acid(upvBLac)and blood glucose(upvGlu).Results There was no statistical differences in upPvO_(2),upSvO_(2),upPvCO_(2),upvBLac and upvGlu at T_(0)-T_(5) between groups(P>0.05).Compared with T_(0),the upPvO_(2),upSvO_(2),and upPvCO_(2) were significantly higher at T_(1)-T_(5) in the two groups(P<0.001).Compared with T_(1),the upPvO_(2) and upSvO_(2) decreased at T_(2) in the two groups of patients,and reduction in upSvO_(2) in group D was statistically significant(P<0.05).The upvBLac in the two groups of patients decreased serially from T_(0) through T_(5).Compared with T_(0),there was a statistically significant reduction in upvBLac from T_(4) to T_(5) in group S and from T_(3) through T_(5) in group D(P<0.05).Compared with T_(0),the change in upvGlu from T_(1) through T_(5) in patients of the two groups was not statistically significant(P>0.05).Conclusion Injection of succinylcholine has minimal impact on blood oxygen saturation in the upper internal jugular ve

关 键 词：颈静脉球 血气分析 麻醉 

分 类 号：R614.2[医药卫生—麻醉学]