小剂量肌松剂在小儿斜视喉罩全麻手术中的应用研究  

Application Research of Low-dose Muscle Relaxant in Laryngeal Mask General Anesthesia in Children with Strabismus

作　　者：张纯 肖权 王欢燕 吕碧 罗秋梅 王柳艳 潘忠玲 ZHANG Chun;XIAO Quan;WANG Huanyan;LYU Bi;LUO Qiumei;WANG Liuyan;PAN Zhongling(Liuzhou Red Cross Hospital,Guangxi,Liuzhou 545000,China;不详)

机构地区：[1]广西柳州市红十字会医院,广西柳州545000

出　　处：《中国医学创新》2022年第34期48-51,共4页Medical Innovation of China

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20200574)。

摘　　要：目的:探讨小剂量肌松剂在小儿斜视喉罩全麻手术中的应用价值。方法:选择2020年5月-2022年3月于柳州市红十字会医院择期行小儿斜视矫正手术的200例患儿作为研究对象,以随机数字表法分为观察组(n=100)与对照组(n=100)。观察组给予咪达唑仑0.1 mg/kg+丙泊酚3 mg/kg+瑞芬太尼2μg/kg+小剂量肌松剂(罗库溴铵0.3 mg/kg)诱导置入喉罩,对照组给予咪达唑仑0.1 mg/kg+丙泊酚3 mg/kg+瑞芬太尼2μg/kg诱导置入喉罩,不使用肌松剂。对比分析喉罩一次性置入成功率、置入时呛咳体动发生率、喉罩漏气发生率、喉痉挛发生率、术中牵拉眼肌时体动发生率、血氧饱和度(SpO_(2))、气道压力、呼气末二氧化碳浓度(ETCO_(2)),手术时间、停药至自主呼吸恢复时间。结果:观察组喉罩一次性置入成功率为100%,高于对照组的95.00%(P<0.05);观察组喉罩漏气发生率、术中牵拉眼肌时体动发生率均显著低于对照组,差异均有统计学意义(P<0.05);两组喉罩置入时呛咳体动发生率、喉痉挛发生率、SpO_(2)、气道压力、ETCO_(2)、手术时间、停药至自主呼吸恢复时间比较,差异均无统计学意义(P>0.05)。结论:小剂量肌松剂在小儿斜视喉罩全麻手术中应用,可有效提高喉罩一次性置入成功率,较好地控制患儿体动,减少喉罩漏气,同时不延长斜视矫正术患儿停药至自主呼吸恢复时间,具有较高的安全性,临床可进一步推广应用。Objective:To explore the application value of low-dose muscle relaxant in laryngeal mask general anesthesia for in children with strabismus.Method:A total of 200 children who underwent elective strabismus correction surgery in Liuzhou Red Cross Hospital from May 2020 to March 2021 were selected as the research subjects and randomly divided into an observation group(n=100)and a control group(n=100)according to the random number table.The observation group was treated with Midazolam 0.1 mg/kg+Propofol 3 mg/kg+Remifentanil 2μg/kg+low-dose muscle relaxant(Rocuronium 0.3 mg/kg)induced anesthesia,and putting into laryngeal mask;the control group was treated with Midazolam 0.1 mg/kg+Propofol 3 mg/kg+Remifentanil 2μg/kg induced anesthesia,and putting into laryngeal mask without muscle relaxant.The success rate of laryngeal mask implantation at one time,the incidence of choking and body movement during implantation,incidence of laryngeal mask air leakage,the incidence of laryngeal spasm,the incidence of body movement during intraoperative eye muscle traction,blood oxygen saturation(SpO_(2)),airway pressure,ETCO_(2),operation time,time from drug withdrawal to spontaneous breathing recovery were compared and analyzed.Result:The success rate of laryngeal mask implantation at one time in the observation group was 100%,which was higher than 95.00%in the control group(P<0.05);the incidences of laryngeal mask air leakage and body movement during intraoperative eye muscle traction in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05);there were no significant differences between the two groups in the incidences of choking and body movement during implantation and laryngeal spasm,SpO_(2),airway pressure,ETCO_(2),operation time and the time from drug withdrawal to spontaneous breathing recovery(P>0.05).Conclusion:The application of low-dose muscle relaxant in laryngeal mask general anesthesia for in children with strabismus can effectively improve

关 键 词：肌松剂 喉罩 斜视 不良反应 

分 类 号：R726.1[医药卫生—儿科]