丙泊酚联合顺式苯磺酸阿曲库铵对腹腔镜胆囊切除术患者肌松效果和血流动力学的影响

Effects of propofol combined with triptolide of cis benzenesulfonate on muscle relaxation and hemodynamics in patients undergoing laparoscopic cholecystectomy

目的 :观察丙泊酚联合顺式苯磺酸阿曲库铵对腹腔镜胆囊切除术(Laparoscopic cholecystectomy,LC)患者的肌松效果和血流动力学的影响。方法 :将收治的90例LC患者按照抽签法随机分为对照组(n=45)和观察组(n=45),两组均行麻醉诱导,对照组给予丙泊酚联合维库溴铵麻醉,观察组给予丙泊酚联合顺式苯磺酸阿曲库铵麻醉,其他辅助麻醉药物均相同。观察两组LC患者肌松效果和气管插管条件,并检测麻醉后(T0)、气管插管时(T1)、切皮时(T2)、拔管时(T3)和拔管后(T4)血流动力学变化。结果 :观察组肌松药起效时间和肌肉松弛恢复时间显著低于对照组;临床作用时间和气管插管良好率显著高于对照组,比较差异有统计学意义。T0时,两组LC患者血流动力学指标大小均无明显差异;T1、T2、T3和T4时,观察组收缩压(SBP)、舒张压(DBP)及心率(HR)大小显著低于同期对照组,与T0时比较无明显差异;而对照组SBP、DBP和HP大小明显高于本组T0时,比较差异有统计学意义。结论 :顺式苯磺酸阿曲库铵联合丙泊酚麻醉,术中肌肉松弛效果好,气管插管评估等级高,且能稳定患者血流动力学,是临床有效的LC麻醉方案之一。

Objective To observe the effects of propofol combined with atracurium cis-benzenesulfonate on muscle relaxation and hemodynamics in patients undergoing laparoscopic cholecystectomy(LC). Methods 90 patients with LC were randomly divided into the control group(n=45) and the observation group(n=45) according to the lottery method. Both groups were induced by anesthesia. The control group was given propofol combined with vecuronium anesthesia. The observation group given propofol combined with triptolide sulfonate anesthesia, and other auxiliary anesthesia drugs are the same. The effect of muscle relaxation and tracheal intubation in two groups of LC patients are observed. During after anesthesia(T0), endotracheal intubation(T1), cutaneous(T2), extubation(T3) and extubation(T4), the changes in hemodynamics were measured. Result The onset time and muscle relaxation recovery time of the muscle relaxants in the observation group were significantly lower than those in the control group. The clinical time and the rate of tracheal intubation were significantly higher in the observation group than in the control group, and the difference was statistically significant. At T0, there were no significant differences in the hemodynamic indexes between the two groups. At T1, T2, T3 and T4, the systolic blood pressure(SBP), diastolic blood pressure(DBP) and heart rate(HR) of the observation group were significantly lower than those of the control group, and compared with T0 was no significant difference. While the control group SBP, DBP and HR levels was significantly higher than T0, and the difference was statistically significant. Conclusion Acetylcidate sulfonate combined with propofol anesthesia, has good muscle relaxion effect and high level of tracheal intubation assessment, and can stabilize hemodynamics, which is one of the clinical effective LC anesthesia program.