不同剂量米库氯胺在小儿腺样体肥大切除术麻醉诱导中的应用效果及安全性比较

Comparison of the Effect and Safety of Different Doses of Mivacurium Chlorideon Anesthesia Induction in Children Undergoing Adenoidectomy

目的 比较不同剂量米库氯胺在小儿腺样体肥大切除术麻醉诱导中的应用效果及安全性。方法 选取2022年1月至2023年6月沁阳市人民医院收治的110例小儿腺样体肥大病例,采用随机数字表分三组。三组均实施全麻下腺样体肥大切除术,A组麻醉诱导中予以0.15 mg/kg米库氯胺,B组予以0.20 mg/kg米库氯胺,C组予以0.25 mg/kg米库氯胺。比较三组气管插管条件与优良率,入室时(T_(0))、插管即刻(T_(1))、插管后5 min(T_(2))、拔管时(T_(3))血流动力学指标[包括心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_(2))],手术时间、呼吸恢复时间、苏醒时间、拔管时间及不良反应发生率。结果 三组气管插管条件比较差异有统计学意义(P<0.05),且B组、C组优良率分别为97.30%和97.14%,均高于A组的78.95%(P<0.05)。A组T_(1)和T_(2)HR和MAP均高于T_(0)(P<0.05),T_(2)和T_(3)均低于T_(1)(P<0.05),T_(3)均低于T_(2)(P<0.05);B组和C组T_(1)HR和MAP均高于T_(0)(P<0.05),T_(2)和T_(3)均低于T_(1)(P<0.05);B组、C组T_(1)和T_(2)HR和MAP均低于A组(P<0.05);A组、B组呼吸恢复时间、苏醒时间均短于C组(P<0.05),B组拔管时间短于A组、C组(P<0.05)。C组不良反应发生率高于A组和B组(P<0.05)。结论 在小儿腺样体肥大切除术麻醉诱导中,与0.15 mg/kg米库氯胺比较,0.20、0.25 mg/kg米库氯胺可改善气管插管条件、稳定血流动力学指标,但0.20 mg/kg米库氯胺还可缩短呼吸恢复时间、苏醒时间与拔管时间,减少不良反应。

Objective To compare the effect and safety of different doses of mivacurium chlorideon in anesthesia induction of children adenoidectomy.Methods 110 cases of adenoidectomy in children admitted to Qinyang People's Hospital from January 2022 to June 2023 were selected and randomly divided into three groups.Adenoidectomy resection under general anesthesia was performed in all three groups,0.15 mg/kg mivacurium chlorideon was given to group A during anesthesia induction,0.20 mg/kg mivacurium chlorideon to group B,and 0.25 mg/kg mivacurium chlorideon to group C.The conditions and excellent rates of tracheal intubation in the three groups were compared,including the hemodynamic indexes[including heart rate(HR),Mean arterial pressure(MAP),blood oxygen saturation(SpO_(2))]at admission(T_(0)),immediately after intubation(T_(1)),5 minutes after intubation(T_(2)),extubation(T_(3)),operation time,respiratory recovery time,recovery time,extubation time and adverse reaction rates.Results There was a statistically significant difference in tracheal intubation conditions among the three groups(P<0.05),and the excellent and good rates of group B and group C were 97.30%and 97.14%,respectively,which were higher than that of 78.95%in group A(P<0.05).The HR and MAP at T_(1) and T_(2) in group A were higher than those at T_(0)(P<0.05),and those at T_(2) and T_(3) were lower than those at T_(1)(P<0.05),which at T_(3) were lower than those at T_(2)(P<0.05).HR and MAP in group B and group C at T_(1) were higher than those at T_(0)(P<0.05),while those at T_(2) and T_(3) were lower than those at T_(1)(P<0.05).The HR and MAP of group B and group C at T_(1) and T_(2) were lower than those of group A(P<0.05).The respiratory recovery time and recovery time of group A and group B were shorter than those of group C(P<0.05).The extubation time of group B was shorter than those of group A and group C(P<0.05).The incidence of adverse reactions in group C was higher than those in group A and group B(P<0.05).Conclusion In the anesthesia induction of pediatric adenoidectomy,compared with 0.15 mg/kg mivacurium chlorideon,0.20 mg/kg mivacurium chlorideon can improve the conditions of tracheal intubation,stabilize hemodynamic indexes.However,0.20 mg/kg mivacurium chlorideon can also shorten respiratory recovery,recovery time and the time of extubation,and reduce adverse reactions.