苯磺顺阿曲库铵复合哌库溴铵预注用于伴心血管疾病患者手术45例

Cisatracurium Besilate Combined with Pipecuronium Bromide Pre- Injection for Treating Cardiovascular Disease in 45 Cases

目的观察苯磺顺阿曲库铵复合哌库溴铵预注用于伴心血管疾病患者手术中的肌肉松弛(简称肌松)效应及不良反应发生情况。方法选择2012年6月至2014年12月医院拟行全身麻醉插管手术伴心血管疾病的患者90例,随机分为对照组及观察组,各45例。对照组患者预注0.9%氯化钠注射液3 m L,观察组患者预注哌库溴铵注射液10μg/kg,6 min后两组患者均行麻醉诱导,然后快速注入苯磺顺阿曲库铵注射液0.15 mg/kg。当达最大阻滞(T1=0)时完成气管插管。结果与麻醉前相比,两组患者插管即刻心率、血压均明显下降(P<0.05),但组间差异无统计学意义(P>0.05);插管1 min后,对照组心率、血压均显著升高(P<0.05),观察组心率、血压则恢复平稳(P>0.05)且优于对照组(P<0.05)。与对照组相比,观察组患者肌松起效时间更短,临床作用时间更长,插管条件更优(P<0.05)。两组患者不良反应发生率无统计学差异(P>0.05)。结论苯磺顺阿曲库铵复合哌库溴铵预注用于伴心血管疾病的手术患者,可减少因血压、心率大幅波动引发的心脏不良事件,并显著缩短肌松起效时间、延长临床作用时间、改善插管条件,药品不良反应少,值得临床推广。

Objective To observe the muscle relaxant effect and adverse reactions of cisatracurium besilate combined with pipecuronium bromide pre- injection for surgery patients with cardiovascular disease. Methods 90 patients with general anesthesia in intubation cardiovascular surgery from June 2012 to December 2014 in the hospital were randomly divided into the control group and the observation group,45 cases in each group. Control group was given pre- injection 0. 9% sodium chloride solution 3 m L,observation group received pre- injection pipecuronium bromide 10 μg / kg. 6 min later the two groups were inducted with anesthesia and then quickly injected cisatracurium besilate 0. 15 mg / kg. When the time reached to maximum block( T1 = 0),applied tracheal intubation. Results At the instant of intubation,the heart rate and blood pressure in both groups were decreased compared with before anesthesia( P < 0. 05),but with no statistical difference between groups( P > 0. 05). 1 min after intubation anesthesia,heart rate and blood pressure of the control group were significantly higher than before( P < 0. 05),while the heart rate and blood pressure of the observation group remained stable( P > 0. 05),compared with control group,the difference was statistically significant( P < 0. 05). The muscle relaxant time in observation group was shorter than control group, the clinical effect time was longer than the control group, and the intubation conditions were better than that of control group( P < 0. 05) The occurrence rate of adverse reactions in the two groups had no statistical difference( P > 0. 05). Conclusion Cisatracurium Besilate combined with pipecuronium bromide pre- injection in treating patients with cardiovascular disease can reduce cardiac adverse events caused by blood pressure and heart rate fluctuations,and significantly shorten the muscle relaxant effect time,prolong the acting time,improve intubation conditions. It has less clinical drug related adverse reactions and is worthy of clinical promotion.