评估全身麻醉后肌松残余3种传统方法的比较

Evaluation on residual neuromuscular blockade after anesthesia:a comparison of 3 traditional methods

目的:比较3种评估麻醉后肌松残留传统方法的优劣。方法:将ASA分级为1~3级的成年患者分为3组,每组30例。A组采用握拳法,B组采用抬头法,C组采用举手法。监测患者入复苏室后10 min及气管拔管后10~20 min的动脉血氧分压,血二氧化碳分压,心率。结果:动脉血氧入室10 min 3组差异无统计学意义(P>0.05),拔管后10 min A组数值明显小于B和C组,差异有统计学意义(P<0.05),而B组和C组间动脉血氧分压数值相近,差异无统计学意义(P>0.05)。动脉血二氧化碳分压和心率,3组比较结果与上相似。结论:抬头法和举手法在肌松残余的判断方面优于握拳法,但这2种方法间比较,差异无统计学意义,举手法在脊柱手术后肌松残余判断方面有独特的优势。

Objective： To explore 3 traditional evaluations on residual neuromuscular blockade after anesthesia and compare their advantages and disadvantages. Methods： Adult patients of ASA grade 1 to 3 were divided into 3 groups,30 in each. Group A was tested with fist clenching method,group B with head rising method and group C with hand rising method. The patients＇ conditions 10 minutes after entering the recovery room and 10 to 20 minutes after tracheal extubation were monitored in terms of arterial partial pressure of oxygen,partial pressure of carbon dioxide in blood and heart rate. Results： There was no significant difference in arterial oxygen between the 3 groups 10 minutes after entering the recovery room（ P〉0. 05）. As for 10 minutes after the extubation,the value was lower in group A than that in group B and group C,with significant difference（ P〈0. 05）. There was no significant difference between group B and group C in arterial partial pressure of oxygen（ P〉0. 05）. The 3 groups had similar results as the above in partial pressure of carbon dioxide in blood and heart rate. Conclusion： Head rising and hand rising methods in evaluation of residual neuromuscular blockade are better than fist clenching method,and the former 2 methods had no significant difference. But hand rising method has unique advantages in residual neuromuscular blockade judgment after spinal surgery.