非去极化肌松药在烧伤患者中应用的研究进展

Advances in the application of non-depolarizing muscle relaxants in burn patients

非去极化肌松药是全身麻醉中常用的一类药物。术中非去极化肌松药和麻醉剂的联合使用有效防止了术中患者的体动反应,手术条件大为改善,麻醉状态也更为稳定[1]。近年来,非去极化肌松药在烧伤患者中出现用药量增加的现象得到越来越广泛的关注。大量研究证明其大面积烧伤患者在全凭静脉麻醉手术时会出现对非去极化肌松药低敏感耐药的现象,导致麻醉过程中肌松药的药量和给药频率增加,也有学者考虑烧伤患者经过多次削痂植皮手术,循环系统处于高代谢期,肾小球滤过率增大,药物清除加速,药物半衰期缩短,导致药物用量增加[2]。本文将对非去极化肌松药在大面积烧伤患者中应用增加的现象及应用现状进行讨论。

Depolarizing muscle relaxants are a class of drugs commonly used in general anesthesia. The combination of non-depolarizing muscle relaxants and anesthetics during surgery effectively prevents body motion reflection in intraoperative patients, surgical conditions improved, anesthesia is more stable. In recent years, The phenomenon that non-depolarizing muscle relaxants appear to increase in drug use in burn patients has received more and more attention, a large number of studies have shown that patients with extensive burns will have low sensitivity to non-depolarizing muscle relaxants during systemic venous anesthesia, resulting in an increase in the dose and frequency of muscle relaxants during anesthesia. Some scholars have considered that patients with burns have undergone multiple resection and skin grafting operations. The circulatory system is in a state of high metabolism, the glomerular filtration rate is increased, the drug clearance is accelerated, and the drug half-life is shortened, resulting in an increase in drug dosage. This article will discuss the increase in the use of non-depolarizing muscle relaxants in patients with extensive burns and it' s application status.