短时效肌松药物米库氯铵在儿科日间手术中的应用Application of short-acting muscle relaxant micuronium in pediatric day surgery
任娜;赵宏娟;杨雪;刘曼嘉;赵晓春;
摘要(Abstract):
目的评价在小儿日间手术中米库氯铵与顺苯磺酸阿曲库铵2种肌松药的应用效果。方法选取2018年2月至2020年2月于沈阳二四二医院行小儿扁桃体切除术患者60例,采用随机数字表法分成米库氯铵组(M组)和顺苯磺酸阿曲库铵组(C组),每组各30例。麻醉诱导:M组给予米库氯铵0.2 mg/kg, C组给予顺苯磺酸阿曲库铵0.1 mg/kg。记录患儿入室时(T_0)、置入气管导管后1 min(T_1)、3 min(T_2)及拔出后1 min(T_3)、3 min(T_4)的脉搏血氧饱和度(SpO_2);记录气道峰压(Ppeak)、平均气道压(Pmean)和呼吸末二氧化碳(PETCO_2);记录肌松起效时间(ThD95)、临床作用时间(TOFR25)、恢复指数(RI);术后需拮抗的患儿人数;手术时长及苏醒时间;记录患儿不良反应的发生情况。结果两组均成功完成手术,M组和C组在T_0、T_1、T_2、T_3、T_4所记录的SpO_2、Ppeak、Pmean、PETCO_2差异无统计学意义(P>0.05);M组患儿苏醒时间[(5.53±2.06)min]短于C组苏醒时间[(9.73±2.53)min],差异有统计学意义(P<0.05);M组肌松起效时间为(115.23±31.75)s、临床作用时间为(14.70±3.15)min、恢复指数为(5.57±1.76)min,均短于C组肌松起效时间(191.60±32.88)s、临床作用时间(42.37±4.58)min、恢复指数(11.57±3.35)min,且差异均具有统计学意义(P<0.05);M组2例使用拮抗药物,C组10例使用拮抗药物,差异有统计学意义(P<0.05);两组患儿不良反应差异无统计学意义(P>0.05)。结论米库氯铵与顺苯磺酸阿曲库铵在用于小儿日间手术中通气效果未见明显差异,使用米库氯铵的患儿术后苏醒快,拮抗药物的使用减少,患儿康复加快。
关键词(KeyWords): 日间手术;扁桃体切除术;肌肉松弛剂;米库氯铵
基金项目(Foundation): 沈阳市中青年科技创新人才支持计划(RC190498)
作者(Authors): 任娜;赵宏娟;杨雪;刘曼嘉;赵晓春;
DOI: 10.14053/j.cnki.ppcr.202107008
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