麻醉诱导期罗库溴胺与阿曲库胺不同注射速度对血流动力学的影响

Hemodynamic changes produced by different administration velocity of rocuronium versus atracurium in anesthesia induction in laparoscopic cholecystectomy

目的观察腹腔镜胆囊切除手术麻醉诱导期不同注射速度的罗库溴胺与阿曲库胺对血流动力学的影响。方法57例择期进行腹腔镜胆囊切除手术的患者随机分为R1、R2、A1、A2四组。监测并记录诱导前,肌松药注射后1、3m in及手术结束时的平均动脉压(MBP)、心率(HR),同时评估插管条件。结果A1组中,肌松药注射后1、3m in的MBP比诱导前有明显下降,HR明显增快。其他各组MBP、HR未观察到明显变化。各组手术结束时的MBP、HR与诱导前比较,差异无统计学意义。结论麻醉诱导时快速注射罗库溴胺与阿曲库胺,阿曲库胺明显影响血流动力学。

Objective to investigate the hemodynamic effects that different velocity of rocuromium and atracorium administration in anesthesia induction intervals in laparoscopic cholecystectomy. Methods Fifty - seven patients who selected the laparoscopic cholecystectomy were divided into four groups by different administration velocity. R1 ：administration rocuronium in 10 seconds; R2 ： administration rocuronium in 30 seconds ： A1： administration atracurium in 10 seconds ; A2 ： administration atracurium in 30 seconds. We monitored the MBP, HR before induction, after administration muscle relaxant 1 and 3 minutes, and ending operation,respectively. We evaluated the intubating condition with Clark and Miralkhur grading also. Results There were significant different at 1 and 3 minutes after administration muscle relaxant compared with before induction MBP, HR in A1 （ MBP decreases and HR increases） ,but no changes were observed in R1 ,R2 and A2. and in every groups there were not different at ending operation compared with before induction. Conclusion There were a little hemodynamic effects after rocuronium bolus than atracurium in anesthesia induction of laparoscopic cholecystectomy.