顺式阿曲库铵在腹腔镜袖状胃切除术全身麻醉中的应用  

Application of cis-atracurium in general anesthesia for laparoscopic sleeve gastrectomy

作　　者：王军 任岩岩[2] 颜朋朋 王圣 WANG Jun;REN Yanyan;YAN Pengpeng;WANG Sheng(Department of Anesthesiology,Luoyang Hospital of Traditional Chinese Medicine,Luoyang 471000,China;Department of Anesthesiology,the First Affiliated Hospital of He’nan University of Science and Technology,Luoyang 471000,China;Department of Cardiovascular Surgery,Fuwai Central China Cardiovascular Hospital,Zhengzhou 451460,China)

机构地区：[1]洛阳市中医院麻醉科,洛阳471000 [2]河南科技大学第一附属医院麻醉科,洛阳471000 [3]阜外华中心血管病医院心血管外科,郑州451460

出　　处：《西北药学杂志》2024年第2期154-158,共5页Northwest Pharmaceutical Journal

基　　金：2019年河南省医学科技攻关计划联合共建项目(编号:LHGJ20190798)。

摘　　要：目的研究顺式阿曲库铵对腹腔镜袖状胃切除术(laparoscopic sleeve gastrectomy,LSG)全身麻醉患者应激反应及血流动力学的影响。方法选取行LSG的患者117例,用随机数字表法分为A组(58例,静脉注射顺式阿曲库铵)和B组(59例,静脉注射维库溴铵)。比较2组不同时间点应激反应指标、血流动力学指标、麻醉诱导时间、肌松恢复指数、麻醉恢复时间,以及不良反应发生情况。结果2组血清P物质(substance P,SP)、皮质醇(cortisol,Cor)、C-肽(C-peptide,C-P)、肾上腺素(epinephrine,E)、晚期氧化蛋白产物(advanced oxidation protein products,AOPP)、平均动脉压(mean arterial pressure,MAP)、血氧饱和度(pulse oxygen saturation,SpO_(2))基础值,T_(1)最大抑制时SP、Cor、C-P、E、AOPP、MAP、SpO_(2)比较,差异均无统计学意义(P>0.05);与SP、Cor、C-P、E、AOPP、MAP、SpO_(2)基础值比较,2组T_(1)最大抑制时SP、Cor、C-P、E、AOPP、MAP、SpO_(2)均无明显变化(P>0.05)。与A组比较,B组麻醉诱导时间缩短[(248.54±36.95)s vs.(190.34±25.51)s],肌松恢复指数增大[(26.58±5.17)vs.(34.15±5.17)],麻醉恢复时间延长[(23.68±4.12)min vs.(33.62±5.78)min],P<0.05。2组心率失常、恶心呕吐、肌肉颤抖、皮疹发生率比较,差异均无统计学意义(P>0.05)。结论顺式阿曲库铵对患者应激反应及血流动力学均无明显影响,在进行麻醉诱导时较维库溴铵起效慢,但恢复时间短,且无肝、肾依赖。Objective To study the effects of cis-atracurium on the stress response and hemodynamics of patients undergoing laparoscopic sleeve gastrectomy(LSG)under general anesthesia.Methods One hundred and seventeen patients undergoing LSG were randomly divided into group A(58 cases,intravenous injection of cis-atracurium)and group B(59 cases,intravenous injection of vecuronium)by using a random number table.The stress response indicators and hemodynamic indicators at different time points were compared between the 2 groups.The anesthesia induction time,muscle relaxation recovery index,anesthesia recovery time,and adverse reactions were also compared between the 2 groups.Results The baseline values of serum substance P(SP),cortisol(Cor),C-peptide(C-P),epinephrine(E),advanced oxidation protein products(AOPP),mean arterial pressure(MAP),and pulse oxygen saturation(SpO_(2))in the 2 groups,and the values of SP,Cor,C-P,E,AOPP,MAP,and SpO_(2) at the time of maximum T_(1) inhibition were compared,and there was no significant difference(P>0.05).Compared with the baseline values of SP,Cor,C-P,E,AOPP,MAP,and SpO_(2),there was no significant change in SP,Cor,C-P,E,AOPP,MAP,and SpO_(2) at the time of maximum T_(1) inhibition in the 2 groups(P>0.05).Compared with group A,the anesthesia induction time was shortened[(248.54±36.95)s vs.(190.34±25.51)s],the muscle relaxation recovery index was increased[(26.58±5.17)vs.(34.15±5.17)],and the anesthesia recovery time was prolonged in group B[(23.68±4.12)min vs.(33.62±5.78)min](P<0.05).The incidence of arrhythmia,nausea and vomiting,muscle tremor,and rash were compared between the 2 groups,and there was no significant difference(P>0.05).Conclusion Cis-atracurium has no obvious effect on the stress response and hemodynamics,and it has a slower onset of action than vecuronium during anesthesia induction,but a shorter recovery time,and it is not liver or kidney dependent.

关 键 词：腹腔镜袖状胃切除术 顺式阿曲库铵 应激反应 血流动力学 

分 类 号：R971[医药卫生—药品]