米库氯铵注射液对比阿曲库铵作为短效肌松药在小儿斜视手术中的应用效果  

Effect of Micuronium Chloride Injection Versus the Application of Atracurium as a Short-acting Muscle Relaxant in Pediatric Strabismus Surgery

作　　者：周丽 罗志雄 ZHOU Li;LUO Zhi-xiong(Xiamen Eye Center,Xiamen University,Fujian Key Laboratory of Eye Table and Corneal Diseases,Xiamen Key Laboratory of Eye Table and Corneal Diseases,Xiamen Eye Diseases,Xiamen Clinical Medical Research Center of Eye Diseases,Xiamen 361001,China)

机构地区：[1]厦门大学附属厦门眼科中心,福建省眼表与角膜病重点实验室,厦门市眼表与角膜疾病重点实验室,厦门市眼部疾病重点实验室,厦门市眼部疾病临床医学研究中心,福建厦门361001

出　　处：《海峡药学》2024年第7期73-76,共4页Strait Pharmaceutical Journal

摘　　要：目的分析米库氯铵注射液作为短效肌松药在小儿斜视手术中的应用效果。5方法选取2019年1月~2020年1月拟在我院行斜视矫正手术患儿1000例,将其采用数字随机表法随机分为对照组(500例)和观察组(500例),两组患儿均于全麻气管插管下实施斜视矫正手术,对照组患儿采用方案(依次静注咪唑安定2 mg,芬太尼2μg·kg^(-1),丙泊酚2 mg·kg^(-1),阿曲库铵0.5 mg·kg^(-1))诱导麻醉,观察组患儿采用(依次静推咪唑安定2 mg,芬太尼2μg·kg^(-1),米库氯铵注射液0.2 mg·kg^(-1),丙泊酚2 mg·kg^(-1))方案诱导麻醉。两组患儿均持续静脉泵入丙泊酚,瑞芬太尼维持麻醉。监测、收集两组患儿围麻醉期血流动力学指标(SBP、DBP、MAP和HR)、Ⅰ级插管条件率、拔管时间、术后不良事件。并对上述指标进行组间比较。结果①血流动力学稳定性比较:两组患儿T_(0)时SBP、DBP、MAP、HR组间差异无统计学意义(P>0.05);两组患儿T_(1)、T_(2)时SBP、DBP、MAP较T_(0)下降(Pkg^(-1)<0.05),T_(3)基本回升至T_(0)水平,其中观察组患儿T_(1)、T_(2)时SBP、DBP、MAP低于对照组患儿(P<0.05);两组患儿HR在T_(1)、T_(2)时略微下降,T_(3)则下升至T_(0)水平,组间差异无统计学意义(P>0.05)。②肌松效果比较:观察组患儿拔管时间明显较对照组患儿短,而Ⅰ级插管条件率均明显高于对照组患儿,组间差异有统计学意义(P<0.05);③不良事件率比较:两组患儿术后均未出现残余肌松及呼吸道事件,两组患儿术后恶心、呕吐率组间差异无统计学意义(P>0.05)。结论米库氯铵作为短效肌松药用于小儿斜视手术,可为手术提供良好肌松条件,促进手术顺利进行,且并未增加额外不良反应,对血流动力学指标影响时间短、波动范围小,对小儿斜视手术利大于弊。OBJECTIVE To analyze the efficacy of micuronium chloride injection as a short-acting muscle relaxant in pediatric strabismus surgery.METHODS Selected 1000 children planned to undergo strabismus correction surgery in our hospital from January 2019 to January 2020,it was randomly divided into the control group(500 cases)and the observation group(500 cases).Both groups of children underwent strabismus surgery under endotra-cheal intubation under general anesthesia,the control group was used(intravenous imidazepam 2 mg,Fentanyl,2μg·kg^(-1),Propofol 2 mg·kg^(-1),Arracurium 0.5 mg·kg^(-1))to induced anesthesia,children in the observation group was used(imidazolium 2 mg,Fentanyl,2μg·kg^(-1),Micuronium chloride Injection 0.2 mg·kg^(-1),Propofol 2 mg·kg^(-1)to induce anesthesia.Children in both groups received a continuous intravenous pump of propofol and anesthesia was maintained with remifentanil.The hemodynamic indicators(SBP,DBP,MAP,and HR),grade I intubation condition rate,time to extubation,and postoperative adverse events were monitored and collected in both groups.And the above indicators were compared between the groups.RESULTS①Comparison of hemodynamic stability:There was no statistically significant difference between the two groups in SBP,DBP,MAP,and HR at T_(0)(P>0.05);The SBP,DBP,and MAP of children in the two groups decreased compared to T_(0)at T_(1)and T_(2)(P<0.05),and T_(3)basically recovered to T_(0)level.The SBP,DBP,and MAP of children in the observation group at T_(1)and T_(2)were lower than those in the control group(P<0.05);There was no statistically significant difference between the two groups(P>0.05).②Comparison of muscle relaxation effects:The completion time and extubation time of intubation in the observation group were significantly shorter than those in the control group,while the condition rate of grade I intubation and the onset time of muscle relaxation were significantly higher than those in the control group,with statistically significant differences between the groups(P<0.

关 键 词：小儿斜视手术 米库氯铵注射液 短效肌松药 肌松效果 血流动力学 不良事件率 

分 类 号：R969.4[医药卫生—药理学]