摘要
目的：减少老年患者肌松用药量和术后肌松残余反应肌松残余效应（postoperative residual curarization,PORC）,为围术期老年患者提供安全保障。方法：择期行全麻腹部手术的老年患者100例,性别不限,年龄56-70岁,体质量55-65 kg,ASA分级Ⅰ-Ⅱ级,采用随机数字表法将其随机分为2组（n=50）。A组持续泵入阿曲库铵3.3-6.7μg·min^-1·kg^-1,缝合腹膜后停止追加,术后根据临床表现拔管;B组使用闭环肌松注射系统自动泵入阿曲库铵2.5μg·min^-1·kg^-1,当术中肌肉四次成串刺激（train-of-four stlmulation,TOF）≥40%时,快速泵入阿曲库铵0.2 mg/kg,缝合腹膜后停止泵入,术后当TOF≥90%时拔管。2组均不拮抗肌松。记录2组术中使用的阿曲库铵量、术后拔管时间、拔管时TOF值及拔管后10 min TOF值。结果：与A组比较,B组患者的阿曲库铵使用量减少,术后拔管时间更短,拔管后TOF值大,术后PORC发生率低（P〈0.05）。结论：老年患者的全麻手术中使用闭环肌松注射系统,能够满足术中肌松需要,肌松药使用量少,术后患者肌松恢复好,术后PORC发生率低,优于传统微量泵持续输注肌松药物。
Objective To decrease the dosage and residual effect of the muscle relaxant for the elderly patients to enhance their safety during preoperative period. Methods One hundred of ASA Ⅰ and Ⅱ elderly patients undergoing abdominal operation under anesthesia were divided equally into group A and B with random digit table, who aged from 56 to 70 years old and weighed from 55 to 65 kg. In group A, the patients were injected with atracurium at the velocity of3.3 to 6.7 μg·min^-1·kg^-1until their peritonea were sutured, and clinical manifestations were investigated to determine if the extubation could be executed; In group B, the patients were administered with atracurium by the close-loop muscle relaxant injection system at the velocity of 2.5 μg· min^-1·kg^-1, and received atracurium with the quantity of 0.2 mg/kg in case the train-of-four stimulation（TOF） was not less than 40% until their peritonea were sutured, and the extubation was performed in case the TOF was not less than 90%. The indexes of the two groups were recorded, including the dosage of atracurium, time point of postoperative extubation as well the TOF values when or 10 min after extubation was carried out. Results When compared with group A, group B had significantly lower dosage of atracurium, shorter time to extubation, higher TOF value after extubation and lower incidence rate of postoperative residual curarization（PORC）, with P〈0.05. Conclusion Close-loop muscle relaxant injection system behaves better than the traditional micro pump in dosage and PORC.
出处
《医疗卫生装备》
CAS
2015年第11期81-83,共3页
Chinese Medical Equipment Journal
关键词
老年人
全麻
阿曲库铵
闭环肌松注射系统
elderly patient
general anesthesia
atracurium
close-loop muscle relaxant injection system
