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两种不同吸入麻醉药吸入1.3倍MAC对患儿术中罗库溴铵持续输注速率的影响

杨建平   

  1. 陕西省咸阳市武功县人民医院
  • 收稿日期:2018-07-02 修回日期:2018-08-23 出版日期:2018-08-25

The Effect of Two Different Inhaled Anesthetics Inhaling 1.3 times MAC on the Rate of Rocuronium Continuous Infusion during the Operation of Children

YANG Jianping   

  1. The people''s Hospital of Wugong County, Xianyang, Shaanxi
  • Received:2018-07-02 Revised:2018-08-23 Online:2018-08-25

摘要: 目的:探究七氟烷以及异氟烷两种不同吸入麻醉药吸入1.3倍最低有效肺泡浓度(MAC)对患儿术中罗库溴铵持续输注速率的影响。方法:选取我院2016年2月至2017年4月收治的全身麻醉下择期行手术的患儿90例作为研究对象,随机分为研究组1、研究组2以及对照组,每组各30例。三组患儿均通过丙泊酚进行麻醉,罗库溴铵的给药方式为0.6mg·kg-1的剂量进行静脉滴注并行气管插管,输注过程中借助肌松监测仪连续4次刺激腕部的尺神经,分别记录手指发生肌抽搐的时间,分别为T1、T2、T3、T4。罗库溴铵的使用条件为T1恢复至初始剂量的5%水平,使用过程中通过调节滴注速率维持T1在9%左右,T1在5 min内保持稳定则将滴注速度调至初始速率,研究组1、研究组2以及对照组分别吸入七氟烷、异氟烷以及丙泊酚,用量保持呼气末浓度为1.3MAC左右即可,对比各组患儿在10、20、30 min后罗库溴铵速率的变化,对比各组患儿的不良反应发生率。结果:各组患儿不同时间的罗库溴铵滴注速度均为:研究组2<研究组1<对照组(P<0.05);研究组2患儿的恢复指数大于其他组(P<0.05);各组患儿的不良反应发生率,差异无统计学意义(P<0.05)。结论:七氟烷以及异氟烷麻醉药吸入1.3倍MAC能够降低患儿术中罗库溴铵持续输注速率,在一定范围内异氟烷效果强于七氟烷,但对患儿的不良反应发生情况无直接影响。

Abstract: Objective:To investigate the effect of sevoflurane and isoflurane inhaled anesthetics of 1.3 times MAC inhalation on the rate of rocuronium continuous infusion during the operation of children. Methods:A total of 90 cases of children admitted in our hospital to undergo the general anesthesia surgery from February 2016 to April 2017 were randomly divided into study group 1, study group 2 and control group. These three groups of patients were anesthetized with propofol, rocuronium was administrated for the amount of 0.6 mg·kg-1 in intravenous infusion and tracheal intubation, and during the infusion process, wrist ulnar nerve was given stimulation for 4 consecutive times using muscle relaxation monitor. Times for fingers muscle convulsion were recorded and their occurrence times were T1, T2, T3, T4. Rocuronium could be used under the condition that T1 returned to 5% original dose, and during the process, T1 was maintained at about 9% by adjusting the infusion rate. If T1 was stable within 5 min, the infusion rate would be adjusted to the initial rate. Study 1 group, study 2 group and control group inhaled sevoflurane, isoflurane and propofol respectively, and the dosage amount should ensure that the end expiratory concentration was at about 1.3 MAC. The variation of rocuronium infusion rate was compared between the three groups after 10, 20 and 30 min, and the incidence of adverse reaction was compared as well. Results:Comparison of rocuronium infusion rate between three groups was study group 2