不同浓度顺式阿曲库铵对甲状腺癌根治术患者维持肌松的效果观察  

Effects of Different Concentrations of Cisatracurium on the Maintenance of Muscle Relaxation in Patients Underwent Radical Thyroidectomy

作　　者：甄万里 魏金聚[1] 宋磊军 ZHEN Wanli;WEI Jinju;SONG Leijun(The 7th People's Hospital of Zhengzhou,Zhengzhou,450000)

机构地区：[1]河南省郑州市第七人民医院,450000

出　　处：《实用癌症杂志》2024年第1期106-109,共4页The Practical Journal of Cancer

摘　　要：目的探究甲状腺癌根治术患者接受不同浓度顺式阿曲库铵维持肌松的效果。方法随机选取行甲状腺癌根治术的患者76例,所有患者均采用舒芬太尼+依托咪酯+顺式阿曲库铵+咪达唑仑麻醉,顺式阿曲库铵+丙泊酚+瑞芬太尼维持,随后行甲状腺癌根治术。采用简单随机分组法分为低浓度组和高浓度组,各38例。低浓度组顺式阿曲库铵剂量为0.15 mg/kg,高浓度组剂量为0.2 mg/kg。对比两组患者麻醉前、插管前1 min、拔管后1 min,两组患者生命体征[心率(HR)、舒张压(DBP)、收缩压(SBP)]、药物作用状况(起效时间、作用时间、睁眼时间、肌松恢复指数)、肌电图水平[0%twiwch(TW)时间、药物注射30 min后TW值、药物注射30 min肌电图(EMG)阳性率]、术后3 d内不良反应(肌肉颤抖、恶心、低血压、心动过缓)发生率。结果插管前1 min较麻醉前,两组患者HR、MAP水平均有下降(P<0.05),且两组比较无统计学差异(P>0.05),插管后1 min较麻醉前,两组患者HR、MAP比较无统计学差异(P>0.05)。低浓度组患者起效时间长于高浓度组,睁眼时间短于高浓度组(P<0.05),两组患者作用时间、恢复指数、0%TW时间、注射药物30 min后TW值、EMG阳性率比较无统计学差异(P>0.05)。术后3 d内,低浓度组患者不良反应发生率低于高浓度组(P<0.05)。结论在甲状腺癌根治术中使用0.15 mg/kg浓度的顺式阿曲库铵维持肌松,可在保证较好作用效果的情况下,帮助患者快速复苏,同时减少术后并发症,具有临床使用价值。Objective To explore the effects of different concentrations of cisatracurium on the maintenance of muscle relaxation in patients undergoing radical thyroidectomy.Methods 76 patients who underwent radical thyroidectomy were randomly selected.All patients were given sufentanil+etomidate+cisatracurium+midazolam for anesthesia induction and given cisatracurium+propofol+remifentanil for anesthesia maintenance and then underwent radical thyroidectomy.The patients were divided into low concentration group(38 cases)and high concentration group(38 cases)by the simple random grouping method.The dose of cisatracurium was 0.15 mg/kg in low concentration group and 0.2 mg/kg in high concentration group.The vital signs[heart rate(HR),diastolic blood pressure(DBP),systolic blood pressure(SBP)]before anesthesia,at 1 min before intubation and at 1 min after extubation,drug action status(onset time,action time,eye-opening time,muscle relaxation recovery index),electromyogram[0%twitch(TW)time,TW value after 30 min of drug injection,positive rate of electromyography(EMG)after 30 min of drug injection]and incidence rates of adverse reactions(muscle tremor,nausea,hypotension,bradycardia)within 3 d after surgery were compared between the two groups of patients.Results Compared with before anesthesia,the HR and MAP of patients in the two groups were decreased at 1 min before intubation(P<0.05),but there were no statistical differences between the 2 groups(P>0.05).The differences in HR and MAP were not statistically significant in the 2 groups at 1 min after intubation compared with those before anesthesia(P>0.05).The onset time of patients in low concentration group was longer than that in high concentration group while the eye-opening time was shorter than that in high concentration group(P<0.05),but there were no statistical differences in the action time,recovery index,0%TW time and TW value and EMG positive rate after 30 min of drug injection between the two groups(P>0.05).Within 3 d after surgery,the incidence rates of adverse reac

关 键 词：顺式阿曲库铵 丙泊酚 甲状腺癌根治术 肌电图 肌松 麻醉质量 

分 类 号：R736.1[医药卫生—肿瘤]