顺式阿曲库铵与罗库溴铵用于全麻气管插管的临床效果分析

Clinical effect analysis of Cisatracurium and Rocuronium for tracheal intubation general anesthesia

目的探讨顺式阿曲库铵和罗库溴铵分别用于全麻诱导气管插管的效果。方法将124例行全麻气管插管腹部手术的患者随机分为顺式阿曲库铵组和罗库溴铵组,各62例,经静脉注入咪达唑仑0.1 mg/kg,芬太尼3μg/kg进行麻醉诱导,待患者意识和睫毛反射消失后,顺式阿曲库铵组给予顺式阿曲库铵0.15 mg/kg,罗库溴铵组给予罗库溴铵0.6 mg/kg后行气管插管,比较气管插管的总有效率及两组患者诱导前、插管后1、5 min时平均动脉压(MAP)、脉搏氧饱和度(SpO2)、心率(HR)的变化,记录全麻诱导的起效时间、作用时间、恢复指数及组胺释放情况。结果罗库溴铵组气管插管总有效率为95.2%,与顺式阿曲库铵组(88.6%)比较差异有统计学意义(χ2=1.74,P<0.05);两组患者插管后1 min的MAP、HR明显上升(P<0.05),5 min后与诱导前无明显差异;罗库溴铵组的起效时间和作用时间较短,恢复指数也明显低于顺式阿曲库铵组,差异有统计学意义(P<0.05)。结论罗库溴铵用于全麻气管插管术的起效时间短,恢复迅速,是临床上较理想的肌松药。

Objective To investigate the effect of Cisatracurium and Rocuronium for tracheal intubation of general anesthesia induction.Methods 124 patients who were scheduled for elective surgery and required endotracheal intubation were randomly divided into two groups,with 62 cases in each group,they were given intravenous injection of Midazolam 0.1 mg/kg,Fentanyl 3 μg/kg for anesthesia induction.Then the Cisatracurium group was given Cisatracurium 0.15 mg/kg,and Rocuronium group was given Rocuronium 0.6 mg/kg,Sevoflurane was used to control anesthesia depth after endotracheal intubation.The total effective rate and changes of endotracheal intubation condition,MAP,SpO2 and HR 5 min after intubation in the two groups were compared before endotracheal intubation and after general anesthesia induction.Besides,the clinical onset time,muscle relaxant effect time,muscle recovery index and adverse reactions were also observed.Results Total effective rate of the Rocuronium group （95.2％） for endotracheal intubation was higher than that of the Cisatracurium group （88.6％）,the difference was statistically significant （x2=1.74,P ＜ 0.05）.MAP and HR of two groups were increased obviously compared with preoperative （P ＜ 0.05）,which had no significant difference after 5 min compared with preoperative; the onset time,action time and recovery index of Rocuronium group were significantly lower than those of Cisatracurium group,the differences were statistically significant （P ＜ 0.05）.Conclusion Rocuronium used in endotracheal intubation can obtain lower onset time and recover time,which is an ideal drug of muscle relaxantion.