顺阿曲库铵不同持续泵注速度对上腹部开腹手术肌肉松弛和肌肉松弛恢复的影响

doi:10.3969/j.issn.1674-8115.2021.08.022

上海交通大学学报(医学版) ›› 2021, Vol. 41 ›› Issue (8): 1125-1128.doi: 10.3969/j.issn.1674-8115.2021.08.022

顺阿曲库铵不同持续泵注速度对上腹部开腹手术肌肉松弛和肌肉松弛恢复的影响

贺恺¹(), 罗艳¹, 许春梅², 金卫芳²()

^1.上海交通大学医学院附属瑞金医院麻醉科，上海 200025
^2.民航上海医院/瑞金医院古北分院麻醉科，上海 200336

出版日期:2021-08-28 发布日期:2021-08-13
通讯作者: 金卫芳 E-mail:17621760102@163.com;630792802@qq.com
作者简介:贺恺（1993—），男，住院医师，硕士；电子信箱：17621760102@163.com。
基金资助:
长宁区卫生和计划生育委员会科研课题(20174Y019)

Effects of different continuous infusion rates of cisatracurium on muscle relaxation and recovery of muscle relaxation during upper abdominal laparotomy

Kai HE¹(), Yan LUO¹, Chun-mei XU², Wei-fang JIN²()

^1.Department of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
^2.Department of Anesthesiology, Shanghai Civil Aviation Hospital/Gubei Branch of Ruijin Hospital, Shanghai 200336, China

Online:2021-08-28 Published:2021-08-13
Contact: Wei-fang JIN E-mail:17621760102@163.com;630792802@qq.com
Supported by:
Scientific Research Project of Changning District Health and Family Planning Commission(20174Y019)

摘要/Abstract

摘要：

目的·探究顺阿曲库铵不同持续泵注速度对上腹部开腹手术肌肉松弛和肌肉松弛恢复的影响。方法·选取2019年1月—2020年1月于民航上海医院/瑞金医院古北分院择期行上腹部开腹手术患者60例，按照随机数字表根据术中泵注顺阿曲库铵速度将其分为低剂量［1.0 μg/（kg·min）］组（L组）、中剂量［1.5 μg/（kg·min）］组（M组）和高剂量［2.0 μg/（kg·min）］组（H组），每组各20例。记录并比较3组患者在麻醉诱导期间顺阿曲库铵用量，术中累计泵注剂量，术中肌肉松弛满意度，停药到4个成串刺激（train of four stimulation，TOF）比率恢复至0.25、0.75、0.80、0.90的时间（TOFr 0.25、TOFr 0.75、TOFr 0.80、TOFr 0.90）以及拔管时间。结果·3组患者在麻醉诱导期间顺阿曲库铵用量方面差异无统计学意义（P =0.662）；L组术中累计泵注剂量低于M组和H组（P=0.025）；3组患者在术中肌肉松弛满意度方面差异无统计学意义（P=1.000）。L组患者TOFr 0.25、TOFr 0.75、TOFr 0.80、TOFr 0.90以及拔管时间显著短于M组和H组（P=0.000）；而M组和H组相比上述指标的差异无统计学意义（P>0.05）。结论·在上腹部开腹手术中以1.0 μg/（kg·min）的速度持续泵注顺阿曲库铵即可提供良好的肌肉松弛状态。泵注剂量增大并不能明显提升肌肉松弛效果，反而会延长肌肉松弛恢复时间以及拔管时间。

关键词: 顺阿曲库铵, 持续泵注速度, 上腹部开腹手术, 肌肉松弛, 肌肉松弛恢复

Abstract:

Objective·To investigate the effects of different continuous infusion rates of cisatracurium on muscle relaxation and recovery of muscle relaxation in upper abdominal laparotomy.

Methods·From January 2019 to January 2020, 60 patients scheduled for upper abdominal laparotomy in Shanghai Civil Aviation Hospital/Gubei Branch of Ruijin Hospital were randomly divided into low dosage [1.0 μg/(kg·min)] group (L group), middle dosage [1.5 μg/(kg·min)] group (M group) and high dosage [2.0 μg/(kg· min)] group (H group), according to the speed of intraoperative pump injection of cisatracurium, with 20 cases in each group. The amount of cisatracurium during the induction period, the cumulative pumping dosage during the operation, intraoperative muscle relaxation satisfaction, the time from drug withdrawal to the train of four stimulation (TOF) ratio recovery to 0.25, 0.75, 0.80 and 0.90 (TOFr 0.25, TOFr 0.75, TOFr 0.80, TOFr 0.90) and extubation time were recorded and compared among the three groups.

Results·There was no significant difference in the dosage of cisatracurium during induction among the three groups (P=0.662). The cumulative pump the dosage in the L group was lower than those in the M and H groups (P=0.025). There was no significant difference in intraoperative muscle relaxation satisfaction among the three groups (P=1.000). TOFr 0.25, TOFr 0.75, TOFr 0.80, TOFr 0.90 and extubation time in the L group were significantly shorter than those in the M and H groups (P=0.000), but there was no significant difference between M group and H group (P>0.05).

Conclusion·Continuous infusion of cisatracurium at the rate of 1.0 μg/(kg·min) during upper abdominal laparotomy can provide a good state of muscle relaxation. The increase of pump dosage can not significantly improve the effect of muscle relaxation, but can prolong the recovery time of muscle relaxation and extubation time.

Key words: cisatracurium, continuous pumping rate, upper abdominal laparotomy, muscle relaxation, muscle relaxation recovery

中图分类号:

R614

贺恺, 罗艳, 许春梅, 金卫芳. 顺阿曲库铵不同持续泵注速度对上腹部开腹手术肌肉松弛和肌肉松弛恢复的影响[J]. 上海交通大学学报(医学版), 2021, 41(8): 1125-1128.

Kai HE, Yan LUO, Chun-mei XU, Wei-fang JIN. Effects of different continuous infusion rates of cisatracurium on muscle relaxation and recovery of muscle relaxation during upper abdominal laparotomy[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(8): 1125-1128.

图/表 3

参考文献 13

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Index	L group （n=20）	M group （n=20）	H group （n=20）	t/χ² value	P value
Age/year	58.35±9.36	52.70±10.02	51.00±12.49	2.582	0.084
Gender/n（%）				0.000	1.000
Male	12 （60.0）	12 （60.0）	12 （60.0）
Female	8 （40.0）	8 （40.0）	8 （40.0）
Body weight/kg	66.55±12.16	66.63±11.24	64.40±9.75	0.259	0.084
Height/cm	166.85±7.18	165.85±7.23	164.80±8.92	0.334	0.711

Index	L group （n=20）	M group （n=20）	H group （n=20）	t/χ² value	P value
Age/year	58.35±9.36	52.70±10.02	51.00±12.49	2.582	0.084
Gender/n（%）				0.000	1.000
Male	12 （60.0）	12 （60.0）	12 （60.0）
Female	8 （40.0）	8 （40.0）	8 （40.0）
Body weight/kg	66.55±12.16	66.63±11.24	64.40±9.75	0.259	0.084
Height/cm	166.85±7.18	165.85±7.23	164.80±8.92	0.334	0.711

Index	L group （n=20）	M group （n=20）	H group （n=20）	t/χ² value	P value
Induction dosage/mg	13.38±2.36	13.13±2.36	12.73±2.10	0.416	0.662
Cumulative pumping dosage/mg	6.26±3.47	8.10±7.31	8.85±5.14	3.949	0.025
Muscle relaxation satisfaction/n（%）				1.137	1.000
Satisfactory	18（90.0）	17（85.0）	18（90.0）
General	1（5.0）	1（5.0）	1（5.0）
Unsatisfactory	1（5.0）	2（10.0）	1（5.0）

Index	L group （n=20）	M group （n=20）	H group （n=20）	t/χ² value	P value
Induction dosage/mg	13.38±2.36	13.13±2.36	12.73±2.10	0.416	0.662
Cumulative pumping dosage/mg	6.26±3.47	8.10±7.31	8.85±5.14	3.949	0.025
Muscle relaxation satisfaction/n（%）				1.137	1.000
Satisfactory	18（90.0）	17（85.0）	18（90.0）
General	1（5.0）	1（5.0）	1（5.0）
Unsatisfactory	1（5.0）	2（10.0）	1（5.0）

Index	L group （n=20）	M group （n=20）	H group （n=20）	t/χ² value
TOFr 0.25/min	34.05±10.88^①②	57.25±17.74	61.00±17.87	16.992
TOFr 0.75/min	51.30±15.23^①②	83.40±27.25	81.70±19.03	14.647
TOFr 0.80/min	53.60±15.57^①②	86.75±28.40	85.50±21.85	13.877
TOFr 0.90/min	56.15±16.22^①②	92.60±30.12	89.50±22.40	14.655
Extubation time/min	62.40±18.92^①②	100.90±30.37	101.70±23.35	16.580

顺阿曲库铵不同持续泵注速度对上腹部开腹手术肌肉松弛和肌肉松弛恢复的影响

Effects of different continuous infusion rates of cisatracurium on muscle relaxation and recovery of muscle relaxation during upper abdominal laparotomy

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