顺式阿曲库铵预注射联合无通气快速诱导在急诊饱胃患者全麻中的应用

The application of cisatracurium pre-injection combined with no ventilation during rapid sequence induction of anesthesia in full stomach patients

目的探讨顺式阿曲库铵预注射联合无通气快速诱导在急诊饱胃患者全麻中应用的安全性和可行性。方法 37例拟行全麻下急诊手术的饱胃患者,诱导前静脉给予顺式阿曲库铵0.02mg/kg预注射,面罩吸入纯氧3min后行静脉快速诱导,诱导期间不实施正压辅助通气,观察并记录诱导前后HR、SpO2、BP的变化及诱导过程中呛咳、呕吐、反流、误吸的发生率。结果T0、T1、T2与T3各时点的SpO2分别为(97.62±1.46)%、(99.78±0.48)%、(99.70±0.85)%和(99.92±0.28)%。诱导过程平稳,气管插管前后SpO2无显著变化;诱导过程中无缺氧、呕吐、反流、误吸发生,且插管条件较为理想。结论对非困难气道的急诊饱胃患者全麻诱导中应用顺式阿曲库铵预注射联合无通气快速诱导技术是安全、可行的。

Objective To investigate the safety and the feasibility of applying cisatracurium pre-injection combined with no ventilation during rapid sequence induction of anesthesia in full stomach patients. Methods 37 patients with full stomach under-going general anesthesia were pre-injected cisatracurium 0.02mg/kg and inhaled 100% oxygen via face mask for 3 min without positive-pressure ventilation before induction of anesthesia. HR,SpO2,BP,ECG were monitored before, during and after the in-duction. The incidence of bucking, vomiting, regurgitation and aspiration were recorded. Results The SpO2 at T0,T1,T2 and T3, （97.62±1.46）%、（99.78±0.48）%、（99.70±0.85）% and （99.92±0.28）%. There were no significant changes on SPO2 and no hypoxia, regurgitation and aspiration took place in any cases. The intubation was ideal. Conclusion The technique of applying cisatracuri-um pre-injection with no ventilation during rapid sequence induction of anesthesia on the full stomach patients is safe and feasi-ble.