闭环自反馈系统输注罗库溴铵在肝脏手术中的应用

Continuous infusion of rocuronium with close-loop auto-feedback system in hepatic surgery

目的研究闭环自反馈系统持续输注罗库溴铵维持开腹肝脏手术肌松可行性和临床效果。方法肝脏手术患者30例(ASA I/II),随机分为罗库溴铵闭环自动持续输注组(A组15例)和手动间断推注组(B组15例),在肌松监测下记录患者的恢复指数、拮抗时间、恢复时间和罗库溴铵平均用量并分析其相关性。记录外科医生满意度。结果两组患者的罗库溴铵恢复指数没有差异,A组拮抗时间和恢复时间短于B组(P<0.01),且与罗库溴铵平均用量有显著相关性(P<0.01)。两组患者均没有出现呼吸系统并发症或其他不良事件。B组的外科满意度更高(P<0.01)。结论肝脏手术中利用闭环自动反馈系统持续输注罗库溴铵安全可行,可减少肌松药用量,降低肌松药残余作用风险。

Objective To assess the clinical effect of continuous infusion of roeuronium wlth close-toop auto-reeu-back system on laparotomic hepatic surgery. Methods Thirty patients （ ASA I/II） underwent hepatic surgery were randomized divided into continuous infusion of rocuronium group （ group A, n = 15 ） and intermittent bolus infusion group （ group B, n = 15 ）. Recovery index, antagonistic time, recovery time and the average amount of rocuronium were compared between the two groups. Surgeons＇ satisfactory scores were recorded. Results There was no significant difference inrecovery index between the two groups, while antagonistic and recovery time of group A were shorter than those of group B （P 〈0.01 ） , and both correlated with rocuronium average amount （ at 0. 01 level）. Patients in both groups did not show any respiratory complications or other adverse events after extubation. Group B had higher satisfactory scores from surgeons （ P 〈 0. 01 ）. Conclusions Continuous infusion of rocuronium with close-loop auto-feedback system in hepatic surgery was safe. It reduced rocuroium＇s amount, and may Key reduce the risks of residual neuromuscular blockade.