罗库溴铵用于小儿唇腭裂修复术的量效关系及肌松残余的观察

Dose-response relationship and muscle relaxant residual induced by rocuronium in children with cleft lip and palate repair

目的：观察全凭静脉麻醉下不同剂量的罗库溴铵应用于小儿唇腭裂修复术时的起效时间和肌松效应以及拔管时肌松残余发生率。方法：择期全麻小儿唇腭裂修复术96例，年龄1—6岁，按随机数字表分为3组（n=32）。麻醉入睡后，采用TOF—Watch@SX肌松监测仪进行肌松监测，定标成功后，静注罗库溴铵，A、B、C组应用剂量分别为0．6、0．9、1．2mg／kg，观察记录麻醉效果。结果：3组患儿气管插管条件优良率为100％。起效时间随剂量增加而缩短（P〈0．05）。肌松维持时间随剂量增加而延长（P〈0．05）。恢复指数Ⅲ组与Ⅱ组、Ⅰ组相比明显延长（P〈0．05），Ⅱ组与Ⅰ组相比无统计学差异（P〉0．05）。肌松残余发生率Ⅲ组高于Ⅱ组和Ⅰ组（P〈0．05），Ⅱ组与Ⅰ组间差异无统计学意义。结论：罗库溴铵0．6、0．9mg／kg在小儿唇腭裂修复术中获得满意的插管条件，起效和恢复迅速，术后肌松残余发生率低。

Objective： To investigate the effects of rocuronium in the intravenous anesthesia in children with cleft lip and palate repair. Methods： According to random number table, 96 children with cleft lip and palate aged 1 -3 years underwent general anesthesia for surgery were divided into 3 groups （n = 32）. The children in group A, B and C received intravenous injection of rocuronium at 0.6, 0.9 and 1.2 mg/kg, respectively. The anesthesia effects were observed. Aeeelerometry （ TOF-Wateh SX ） was used to monitor neuromuscular transmission. Results： Intubating conditions ranged from good to excellent in all children. The onset time of anesthesia in Group C was significantly shorter（ P 〈 0.05 ） , the duration of neuromuscular block was significantly longer in group C than in group A and B （P 〈 0.05 ）. The recovery index in group C was significantly longer than that in group A and B（P 〈 0.05, A vs B, P 〉 0.05 ）. Muscle relaxant residual incidence in group C was higher than that in group A and B （ P 〈 0.05, A vs B, P 〉 0.05）. Conclusion ： Rocuronium at 0.6 mg/kg or 0.9 mg/kg are effective for excellent tracheal intubation, with faster onset time and recovery time, low incidence of postoperative residual curarization（PORC） in children with cleft lip and palate repair.