两种复合全麻在肾移植术中的临床应用

Comparision of two anesthesia combination regimens for renal transplantation

目的比较维库溴铵一芬太尼和顺式阿曲库铵一瑞芬太尼两组麻醉方案在肾移植术中的应用。方法分析本院108例肾移植手术，按麻醉方案分成I组：维库溴铵一芬太尼（n=45），Ⅱ组：顺式阿曲库铵一瑞芬太尼（n：63）。比较两组麻醉方案中血流动力学、气管拔管时间、术后尿量、肌酐和麻醉并发症的差异。结果I组气管拔管时间（47．5±26．2）min较Ⅱ组（33．5±17．5）min）明显延长（P〈0．05）；两组在血流动力学、术后尿量、肌酐和麻醉并发症方面差异无统计学意义（P〉0．05）。结论两组麻醉方案均能安全应用于’肾移植，但Ⅱ组方案的气管拔管及恢复时间明显缩短，是肾移植更理想的麻醉选择。

Objective This research aimed to compare two regimens of anesthesia （ vecuronium-fentanyl and cisatracurium-remifentanil）for kidney transplantation patients. Methods 108 patients were studied, 45 pa- tients （ Group I ） received balanced anesthesia with vecuronium and fentanyl, to the others 63 （ Group Ⅱ ）, ci- satracurium and remifentanyl was given. Comparison of the difference between the two groups was made on the ex- tubation time, intraoperative hemodynamics, postoperative urine output, serum creatinine and anesthesia compli- cations. Results Extubation time of the Group I was significantly longer than that of Group II （33.5min ± 17.5min, P 〈 0.05 ） , but there was no difference between two groups on intraoperative hemodynamics, postoper- ative urine output, seIum ereatinine and anesthesia complications. Conclusions Both of the two regimens can provide safe anesthesia for kidney transplantation. Patients received regimen of cisatracurium and remifentanil ex- perienced shorter extubation time. This regimen may be a better anaesthesic regimen for renal transplantation.