肌松闭环注射系统在全身麻醉中的应用

Research the close-loop muscle relaxant injection system in general anesthesia

目的:研究闭环肌松注射系统用于全身麻醉的临床效果及安全性。方法:随机选择180例择期全身麻醉患者,ASAI-II级,随机分为两组:闭环肌松注射系统组(C组);E组(E组)。每组90例,C组采用闭环肌松注射系统给予肌松药,E采用麻醉医师临床经验判断给予肌松药。在入室、诱导即刻、插管、切皮、进腹、探查、关腹、缝皮、意识恢复、气管拨管、出室11个时间点(T1～T11),观察记录各项生命指标;记录肌松药总量、诱导苏醒时间、Copper评级、术中体动反应率、麻醉医师满意率及手术医师满意率;记录不良反应。结果:两组一般资料比较、T1-T7各时点生命体征比较无统计学意义(P>0.05)。与E组比较,C组缝皮、意识恢复、气管拨管、出室各时间点呼吸频率及脉搏氧饱和度均升高(P<0.05);C组肌松计数、TOF值在T3-T8时较低(P<0.05),T9-T11时较高(P<0.05);C组插管时间、肌松药总量、拮抗剂用量、诱导苏醒时间均降低(P<0.05);C组Copper评级、麻醉医生满意率、手术医生满意率均升高(P<0.05),术中体动反应率降低(P<0.05);C组术后呼吸抑制、呕吐均降低(P<0.05)。结论:闭环肌松注射系统用于全身麻醉,可以减少肌松药的用量和不良反应,手术麻醉中肌松强度可控性强,术后麻醉苏醒及时。

Objective:To study of closed-loop muscle relaxant injection system(CLMRIS) the clinical efficacy and safety for general anesthesia.Methods:180 cases of randomly selected elective general anesthesia patients,ASA I-II,were randomly divided into two groups:CLMRIS the treatment group(C group);experience in treatment group(E group).Results:Each group of 90 cases,C using the CLMRIS for muscle relaxants,E used to determine clinical experience of anesthesiologists to give muscle relaxants.Respectively,burglary,induced immediately,intubation,skin incision,into the abdomen,exploration,offbellied,sewing skin,awareness of recovery,tracheal tube dial,out of room in 11 time points(T1～T11),observed and recorded MAP,HR,RR,SpO2,muscle relaxants count,TOFR;record of the total muscle relaxants to induce recovery time,Copper ratings,intraoperative body movement response rate,anesthesiologist and surgeon satisfaction rate of satisfaction;record of adverse drug reactions.Conclusion:CLMRIS for general anesthesia,muscle relaxation can reduce drug usage and adverse reactions,muscle relaxant anesthesia intensity control,and postoperative recovery from anesthesia time.