老年麻醉使用罗库溴铵后肌松时效延长的拮抗处理

Antagonism management of prolonged muscle relaxant time after rocuronium bromide in senile anesthesia

目的观察使用罗库溴铵对老年麻醉肌松时效延长而采取拮抗处理的效果。方法 120例使用罗库溴铵实施肌松后出现时效延长的老年麻醉患者,随机分为观察组和对照组,每组60例。两组均采用气管插管全身麻醉,使用罗库溴铵实施肌松,手术完毕对因肌松时效延长患者,观察组使用甲硫酸新斯的明联合盐酸阿托品进行拮抗,常规监护和4个成串刺激(TOF)监测TOF从0~75%,从0~90%,从0至肌松恢复拔管即刻,从拔管即刻至残余肌松完全恢复。对照组使用生理盐水2 ml,常规监护和TOF监测TOF从0~75%,从0~90%,从0至肌松恢复拔管即刻,从拔管即刻至残余肌松完全恢复。两组患者均做好积极处理并发症准备。结果观察组能够快速拮抗肌松缩短时效,对照组肌松时效延长恢复缓慢,两组比较差异具有统计学意义(P<0.05)。结论及时合理使用甲硫酸新斯的明联合盐酸阿托品进行拮抗,可明显缩短老年麻醉肌松时效延长的恢复时间,减少术后并发症。

Objective To observe antagonism management effect of prolonged muscle relaxant time after rocuronium bromide in senile anesthesia. Methods A total of 120 senile anesthesia patients with prolonged muscle relaxant time after rocuronium bromide were randomly divided into observation group and control group, with 60 cases in each group. Both groups received tracheal intubation general anesthesia, and rocuronium bromide for muscle relaxant. The observation group received neostigmine methylsulfate combined with atropine hydrochloride for antagonism due to prolonged muscle relaxant time after surgery. Conventional nursing and trainof-four stimulation(TOF) monitoring were taken in 0~75%, 0~90%, from 0 to extubation at recovery of muscle relaxant, and from extubation at recovery of muscle relaxant to complete recovery. The control group received 2 ml of normal saline. Conventional nursing and TOF monitoring were taken in 0~75%, 0~90%, from 0 to extubation at recovery of muscle relaxant, and from extubation at recovery of muscle relaxant to complete recovery. Both groups received active preparation for complications management. Results The observation group had quick antagonism for shortening muscle relaxant time, while the control group had slow recovery time in prolonged muscle relaxant time. The difference between the two groups had statistical significance(P<0.05). Conclusion Timely implement of neostigmine methylsulfate combined with atropine hydrochloride for antagonism can obviously shorten recovery time of prolonged muscle relaxant and reduce postoperative complications.