米库氯铵和顺苯磺酸阿曲库铵在婴幼儿手术麻醉中对组胺释放的影响

A comparison of effects between mivacurium and cistracurium on histamine release in infants

目的定量观察和比较米库氯铵和顺苯磺酸阿曲库铵用于婴幼儿短时手术中的组胺释放程度及相关不良反应。方法择期行手术治疗的患儿40例,随机数字表法分为两组,每组20例,给予米库氯铵0.2 mg·kg^(-1)(M组),顺苯磺酸阿曲库铵0.15 mg·kg^(-1)(C组)后插管。分别在静脉麻醉后,注射肌松药前(Ta),给予肌松药后4 min(T_b),7 min(T_c)时,采集静脉血样,使用Elisa法测定血浆组胺浓度。在入室基础镇静后(T1),麻醉后未给肌松药前(T_2),给予肌松药后1 min(T_3),3 min(T_4),5 min(T_5),10 min(T_6),记录6个时刻的患儿的心率(HR),平均动脉压(MAP)。观察记录两组麻醉过程相关不良反应。结果与C组相比,M组组胺浓度明显增高(P<0.05)。两组在心率(HR),平均动脉压(MAP)上差异无统计学意义(P>0.05)。两组均未见组胺释放导致的严重不良反应发生。结论在普通小儿手术麻醉中,与顺苯磺酸阿曲库铵相比,米库氯铵可引起更大程度的组胺释放,但两者引起严重不良反应的发生率差异无统计学意义。

Objective To quantitatively compare the effects between mavacurium and cisatracurium on histamine release in infants un-dergoing short-term surgery.Methods Forty infants undergoing short-term selective surgery were randomized into two groups（n =20 for each group）.The infants in group Mwere administered with mivacurium（0.2 mg·kg^-1 ）while those in group C were administered with cisatracurium（0.15 mg·kg^-1 ）for tracheal intubation.Blood samples were collected to quantify plasma histamine concentrations by Elisa method after intravenous anesthesia,before（Ta ）and 4.（Tb ）7 mins（Tc ）after the administration of the muscle relaxant.Mean arterial pressure（MAP）,heart rate（HR）,and related side-effects were observed and recorded.Results The infants in group M had significantly increased plasma histamine concentrations compared with those in group C（P 〈0.05）.No statistically significant differ-ences in HR,MAP and side-effects were found between the two groups（P 〉0.05）.Conclusions For infants with short-term surgery, the relaxant mivacurium caused higher plasma histamine concentration compared with cisatracurium.But there were no significant differ-ences in serious side-effects between them.