顺式阿曲库铵闭环注射系统在腹腔镜手术中的应用

The use of cis-atracurium by guidance of closed-loop muscle relaxant injection system in the laparoscopic surgery

目的探讨顺式阿曲库铵闭环注射在腹腔镜手术中的肌松效果。方法选择腹腔镜手术患者20例,随机均分成闭环注射组(G组)和对照组(C组)。C组持续输注顺式阿曲库铵1.5～2μg·kg-1·min-1直至手术结束前30min;G组输注顺式阿曲库铵0.8μg·kg-1·min-1,设定肌松深度反馈值T1=15%,近手术结束时由研究实施者根据术中肌松监测指标决定停药时机。记录麻醉时间、顺式阿曲库铵的总用量、恢复指数、TOFr75及TOFr90。结果 G组顺式阿曲库铵总用量均明显少于C组(P<0.05),恢复指数、TOFr75及TOFr90明显缩短于C组(P<0.05)。结论与持续输注方式相比,闭环肌松药注射方式肌松药用量更少,恢复指数、TOFr75和TOFr90明显缩短,实现个性化和合理化用药。

Objective To explore the effect of closed-loop muscle relaxant injection system on the dosage of cis-atracuriurru Methods Twenty patients, scheduled to accept laparoscopic surgery, were randomly divided into two groups： continuous infusion group（group C） and guidance group （group G）. Keeping the ram velocity of cis-atraeurium at 1.5-2ug.kg-1 .min 1 in group C until 30 minutes before the end of surgery. Keeping the ram velocity of cis-atracurium at 0. 8ug.kg-1 .min-1 in group G, and setting the feedback value of muscle relaxation depth （T1） at 15%. Reserchers withdrew the relaxant according to the monitoring information nearby the end of surgery. The duration of anesthesia, the total amount of cis-atracurium, recovery index （RI）, TOFr75, and TOFr90 were recorded. Results The total amount of cis-atracurium in group G was lower than group C（P（0.05）. Compared to group C,RI, recovery time, TOFr75 and TOFr90 in group G significantly shortened（P〈0.05）. Conclusion Compared to the continuous injection mode, the total consumption of relaxant in the closed-loop injection system was less; in addition, the RI, TOFr75 and TOFr90 were shortened. It can personalize and rationalize the drug usage.