罗库溴铵在高原地区与平原地区腹部手术患者全麻时的作用情况比较  

Comparison of the effect of rocuronium during general anesthesia in patients undergoing abdominal surgery between plateau area and plain area

作　　者：陈燕 王欣路 丹增卓嘎 冉志超 大边巴 CHEN Yan;WANG Xinlu;Danzeng Zhuoga;RAN Zhichao;DAbianba(Anesthesiology Department,Xi'an People's Hospital/Xi'an Fourth Hospital,Xi'an 710004;Anesthesiology Department,Ngari Prefecture People's Hospital,Ngari 859499,China)

机构地区：[1]西安市人民医院/西安市第四医院麻醉科,陕西西安710004 [2]阿里地区人民医院麻醉科,西藏阿里859499

出　　处：《临床医学研究与实践》2022年第9期30-33,共4页Clinical Research and Practice

基　　金：2020年西藏自治区自然科学基金组团式援藏医学项目[No.XZ2020ZR-ZY91(Z)]。

摘　　要：目的采用加速度肌松监测仪观察高原地区与平原地区腹部手术患者全麻时肌松药罗库溴铵的作用情况。方法选择2020年7月至2021年2月接受全麻开腹手术的80例患者作为研究对象,将2020年7月至2020年10月在高原地区(阿里地区人民医院)拟行开腹手术的40例患者设为A组,将2020年11月至2021年2月在平原地区(西安市第四医院)拟行开腹手术的40例患者设为B组。两组ASA分级均为Ⅰ~Ⅱ级,采用同一加速度肌松监测仪,麻醉诱导时静脉注射0.6 mg/kg罗库溴铵。比较两组患者的罗库溴铵作用情况、插管条件以及麻醉诱导时的不良反应发生情况。结果两组患者的起效时间比较,差异无统计学意义(P>0.05);A组患者的最大阻滞维持时间、临床有效时间、起效时间恢复到75%的时间及RI均明显短于B组(P<0.05)。两组患者的插管条件比较,差异无统计学意义(P>0.05)。B组患者的注射痛发生率高于A组(P<0.05)。结论海拔4000 m以上高原地区患者使用肌松药罗库溴铵时,起效时间与平原地区无明显差异,但临床作用时间及恢复时间明显缩短,0.6 mg/kg罗库溴铵是较为适合的诱导剂量,可以在高原和平原地区均创造满意的插管条件;但平原地区患者的注射痛发生率较高,在临床使用过程中应注意并进行针对性的预处理。在高原地区肌松药使用时应该在肌松监测仪指导下监控肌松情况,缩短追加时间,且要充分考虑到地域差异。Objective To observe the effect of rocuronium during general anesthesia in patients undergoing abdominal surgery in plateau area and plain area by using acceleration muscle relaxation monitor.Methods A total of 80 patients who underwent laparotomy under general anesthesia from July 2020 to February 2021 were selected as the research objects.Forty patients who planned to undergo laparotomy in plateau area(Ngari prefecture people's hospital)from July 2020 to October 2020 were set as group A,and 40 patients who planned to undergo laparotomy in plain area(Xi'an fourth hospital)from November 2020 to February 2021 were set as group B.The ASA grade of the two groups were gradeⅠ-Ⅱ,the same acceleration muscle relaxation monitor was used.The 0.6 mg/kg rocuronium was injected intravenously during anesthesia induction.The effects of rocuronium,intubation conditions and adverse reactions during anesthesia induction were compared between the two groups.Results There was no significant difference in onset time between the two groups(P>0.05);the maximum block maintenance time,clinical effective time,the time of onset time recovered 75%and RI in the group A were significantly shorter than those in the group B(P<0.05).There was no significant difference in intubation conditions between the two groups(P>0.05).The incidence of injection pain in the group B was higher than that in the group A(P<0.05).Conclusion When rocuronium,a muscle relaxant drug,is used in patients at altitude above 4000 m,the onset time is no significant different from that in plain areas,but the clinical action time and recovery time significantly shortened.0.6 mg/kg rocuronium is a more suitable induction dose,which could create satisfactory intubation conditions in both plateau and plain areas;however,the incidence of injection pain in patients in plain area is higher,so we should pay attention to and carry out targeted pretreatment in the process of clinical use.When using muscle relaxants drug in plateau area,we should monitor the muscle relaxant under

关 键 词：高原地区 平原地区 罗库溴铵 全麻 肌松监测仪 插管条件 最大阻滞维持时间 

分 类 号：R614.2[医药卫生—麻醉学]