顺阿曲库铵不同用药方案对腹腔镜胃切除术患者麻醉质量的影响  

Effects of different cis-atracurium regimens on the quality of anesthesia in patients undergoing laparoscopic gastrectomy

作　　者：丁金路 徐宗雪[1] 程敏 Ding Jinlu;Xu Zongxue;Cheng Min(Department of Anesthesiology,General Hospital of Huainan East Hospital Group-Affiliated Hospital of Anhui University of Science and Technology,Huainan 232000,China)

机构地区：[1]淮南东方医院集团总医院,安徽理工大学附属医院麻醉科,安徽省232000

出　　处：《中华消化病与影像杂志（电子版）》2024年第4期373-377,共5页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

摘　　要：目的分析顺阿曲库铵不同用药方案对腹腔镜胃切除术患者术后苏醒、应激及早期恢复质量的影响。方法选取淮南东方医院集团总医院2021年1月至2023年6月拟行腹腔镜胃切除术治疗的80例患者,随机分为间断输注组(n=40)、持续输注组(n=40),2组均采用相同麻醉诱导方案,间断输注组术中每当T1恢复至10%时给予0.03 mg/kg顺阿曲库铵,持续输注组术中首次T1恢复至10%时启动顺阿曲库铵1.4μg/(kg•min)持续静脉输注。对比2组术中肌松维持和恢复情况、术后苏醒质量、围手术期应激指标变化,并通过术后首次排气时间、胃肠功能恢复时间等指标评估2组早期恢复质量。结果间断输注组TOF恢复至75%时间、恢复指数、总用药量、平均给药速度均高于持续输注组(P<0.05)。间断输注组自主呼吸恢复时间、拔管时间高于持续输注组(P<0.05)。2组气腹后即刻、气腹后30 min、手术结束时肾上腺素(E)、去甲肾上腺素(NE)和皮质醇(Cor)均较麻醉诱导前升高(P<0.05);同时点组间应激指标比较,差异无统计学意义(P>0.05)。间断输注组胃肠功能恢复时间高于持续输注组(P<0.05),术后不良反应发生率高于持续输注组(P<0.05)。结论相较于间断输注,持续输注顺阿曲库铵能够在不影响麻醉效果、不加剧应激反应的前提下,促进术后肌松恢复和苏醒、提高早期恢复质量、降低不良反应发生风险。Objective To analyze the effects of different cis-atracurium regimens on postoperative recovery,stress and early recovery quality of patients undergoing laparoscopic gastrectomy.Methods A total of 80 patients who were treated by laparoscopic gastrectomy in General Hospital of Huainan East Hospital Group from January 2021 to June 2023 were selected randomly divided into intermittent infusion group(n=40)and continuous infusion group(n=40).Both groups adopted the same anesthesia induction scheme.The intermittent infusion group was given 0.03 mg/kg cis-atracurium whenever T1 recovered to 10%during operation,and in the continuous infusion group,1.4μg/(kg·min)continuous intravenous infusion of cis-atracurium was initiated when T1 recovered to 10%at the first time.The maintenance and recovery of muscle relaxation during operation,the quality of postoperative recovery and the changes of perioperative stress indexes were compared between the two groups,and the early rehabilitation quality of the two groups was evaluated by the first postoperative exhaust time and gastrointestinal function recovery time.Results The recovery time of TOF to 75%,recovery index,total dosage and average administration speed in the intermittent infusion group were higher than those in the continuous infusion group(P<0.05).The recovery time of spontaneous respiration and extubation time in the intermittent infusion group were longer than those in the continuous infusion group(P<0.05).The evels of epinephrine(E),norepinephrine(NE)and cortisol(Cor)in both groups were higher immediately after pneumoperitoneum,30 min after pneumoperitoneum and at the end of operation compared with before anesthesia induction(P<0.05).At the same time,there was no statistically significant difference in stress indexes between the two groups(P>0.05).The recovery time of gastrointestinal function in the intermittent infusion group was longer than that in the continuous infusion group(P<0.05).The incidence of postoperative adverse reactions in the intermittent infusion

关 键 词：顺阿曲库铵 腹腔镜胃切除术 苏醒 应激 恢复质量 

分 类 号：R614[医药卫生—麻醉学] R735.2[医药卫生—外科学]