米库氯铵与苯磺顺阿曲库铵用于经支气管镜超声引导针吸活检术的临床研究  

Clinical trial of mivacurium chloride and cisatracurium besilate in endobronchial ultrasound-guided transbronchial needle aspiration

作　　者：胡渤 李照菊 贾济 徐波 朱佳宇 HU Bo;LI Zhao-ju;JIA Ji;XU Bo;ZHU Jia-yu(Department of Anesthesiology,Southern Theater General Hospital of the Chinese People’s Liberation Army,Guangzhou 510010,Guangdong Province,China)

机构地区：[1]中国人民解放军南部战区总医院麻醉科,广东广州510010

出　　处：《中国临床药理学杂志》2023年第13期1861-1865,共5页The Chinese Journal of Clinical Pharmacology

基　　金：广东省医学科学技术研究基金资助项目(A2017526)。

摘　　要：目的 观察米库氯铵与苯磺顺阿曲库铵用于经支气管镜超声引导针吸活检术(EBUS-TBNA)的临床疗效。方法 将146例纵膈淋巴结肿大进行EBUS-TBNA的患者,采用数字奇偶法分为A组(给予羟考酮0.05 mg·kg^(-1)+米库氯铵0.2 mg·kg^(-1)麻醉)和B组(给予羟考酮0.05 mg·kg^(-1)+苯磺顺阿曲库铵0.15 mg·kg^(-1)麻醉)。比较2组患者手术时间、麻醉苏醒时间及追加羟考酮量、Ramsay评分、咳嗽评分、血流动力学指标、肌肉松弛程度及药物不良反应发生情况。结果 A组和B组分别纳入72和71例。A组和B组手术时间分别为(29.15±7.47)和(31.82±9.69)min,追加羟考酮量分别为(0.71±0.22)和(0.78±0.26)mg,差异无统计学意义(P>0.05)。A组和B组麻醉苏醒时间分别为(7.81±2.17)和(13.29±3.75)min,Ramsay评分分别为(3.14±1.09)分和(2.04±0.73)分,咳嗽评分分别为(0.29±0.46)分和(0.51±0.53)分,差异均有统计学意义(均P<0.05)。A组手术开始后10 min(T_(3))及手术结束后(T_(4))时刻的MAP、HR均低于B组(P<0.05)。A组T_(4)时刻TOF值高于B组(P<0.05)。A组和B组药物不良反应总发生率分别为4.17%(3例/72例)和14.08%(10例/71例),差异无统计学意义(P>0.05)。结论 与苯磺顺阿曲库铵相比,米库氯铵用于EBUS-TBNA可缩短麻醉苏醒时间、减少羟考酮追加量,镇静深度适中、咳嗽评分低,稳定血流动力学指标,有利于控制神经肌肉阻滞蓄积,且安全性较高。Objective To compare the effect of mivacurium chloride and cisatracurium besilate in endobronchial ultrasound-guided transbronchial needle aspiration(EBUS-TBNA).Methods A total of146 patients with mediastinal lymphadenopathy underwent EBUS-TBNA were divided into group A(anesthetized with oxycodone 0.05 mg·kg^(-1)+mivacurium chloride 0.2 mg·kg^(-1))and group B(anesthetized with oxycodone 0.05 mg·kg^(-1)+cisatracurium besilate 0.15 mg·kg^(-1))by digital parity method.The operation time,anesthesia recovery time,additional oxycodone amount,Ramsay score,cough score,hemodynamic indexes,muscle relaxation degree and adverse drug reactions of the two groups were compared.Results Group A and group B were included 72and 71 patients respectively.The operation time of group A and group B were(29.15±7.47)and(31.82±9.69)min,the amount of oxycodone added were(0.71±0.22)and(0.78±0.26)mg,respectively,with no significant difference(P<0.05).The recovery time of anesthesia in group A and group B were(7.81±2.17)and(13.29±3.75)min;Ramsay scores were 3.14±1.09 and 2.04±0.73;cough score were 0.29±0.46 and 0.51±0.53,the difference was statistically significant(all P<0.05).The MAP and HR at 10 min after surgery(T_(3))and after surgery(T_(4))in group A were lower than those in group B(all P<0.05).The TOF value at T_(4)in group A was higher than that in group B(P<0.05).The total incidence of adverse drug reactions in group A and group B were 4.17%(3 cases/72 cases)and 14.08%(10 cases/71 cases),respectively,with no statistically significant difference(P>0.05).Conclusion Compared with cisatracurium besilate,mivacurium chloride used for EBUS-TBNA can shorten the recovery time from anesthesia,reduce the additional dose of oxycodone,moderate sedation depth,low cough score,and stable hemodynamic indicators.It is beneficial to control the accumulation of neuromuscular blockade with high safety.

关 键 词：支气管镜超声引导针吸活检术 米库氯铵 苯磺顺阿曲库铵 麻醉效果 血流动力学 

分 类 号：R971.2[医药卫生—药品]