米库氯铵与顺苯磺酸阿曲库铵在耳鼻喉科短时手术麻醉中对组胺释放的影响

Comparison of Mivacurium and Cisatracurium on histamine release in otorhinolaryngologic short-term operation

目的定量观察和对比米库氯铵和顺苯磺酸阿曲库铵用于耳鼻喉科的短时手术中时组胺释放水平、对循环系统的影响以及相关的不良反应。方法选取2016年1月~2017年1月于河北省保定市第二医院行耳鼻喉短时手术治疗的患者120例,采用随机数字表法将其分为A、B两组,每组60例。分别给予米库氯铵0.2 mg/kg(A组),顺苯磺酸阿曲库铵0.15 mg/kg(B组)后插管;然后分别在静脉全身麻醉后,注射肌松药之前(T_1),给予肌松药之后4 min(T_2),7 min(T_3)3个时间点,采集研究对象的静脉血样,使用酶联免疫吸附法测定血浆中组胺的浓度,并记录3个时间点患者的心率(HR),平均动脉压(MAP),血氧饱和度(SpO_2)。观察记录两组麻醉过程中各种相关不良反应。结果与B组比较,A组组胺浓度明显增高(P<0.05)。两组HR、MAP和SpO_2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。结论在耳鼻喉科短时手术麻醉过程中,与顺苯磺酸阿曲库铵比较,米库氯铵可导致更高水平的组胺释放,但两者严重不良反应发生情况无明显差异。

Objective To quantitatively compare the effects between Mivacurium and Cisatracurium on histamine release in otorhinolaryngologic short-term operation. Methods A total of 120 short-term operation patients from January2016 to January 2017 in the Second Hospital of Baoding were selected, and they were divided into group A and B according to the random number table method, with 60 cases in each group. The patients received Mivacurium 0.2 mg/kg（group A） and Cisatracurium 0.15 mg/kg（group B） respectively. After intravenous anesthesia, before injecting the muscle relaxant（T1） and 4 min（T2）, 7 min（T3） after injecting, blood samples were collected to test plasma histamine by Elias method. Mean arterial pressure（MAP）, heart rate（HR）, SpO2（%） and related side-effects were recorded. Results The patients in group A had significantly increased plasma histamine compared with those in group B（P 〈 0.05）. No statistically significant differences in HR, MAP, SpO2 and side-effects were found between the two groups（P 〉 0.05）. Conclusion For otorhinolaryngologic short-term operations, Mivacurium caused higher plasma histamine compared with Cisatracurium, while there is no significant difference in side-effects between them.