罗库溴铵用于气管插管的临床观察

目的探讨罗库溴铵用于神经外科患者气管插管的适用条件和不良反应。方法470例ASAⅠ~Ⅲ级行择期颅脑手术的患者,于麻醉前进行Mallampatti气道评估,继而依次静脉注射芬太尼2μg/kg、罗库溴铵0.6mg/kg、异丙酚2mg/kg进行麻醉诱导插管,对声门暴露情况进行Cormack-Lehane分级。观察药物不良反应和插管时患者的运动反应。结果术前预测插管困难患者16人,实际操作中仅5人发生了插管困难,1次完成气管插管占94.7%,2次完成气管插管占4.0%,3次以上完成气管插管占1.3%;药物不良反应占13.4%,插管时患者发生运动反应占6.4%。结论罗库溴铵可以安全地用于神经外科患者气管插管。随着Mallampatti分级的增加,声门暴露的困难性增加,重复插管的概率增加。

A Clinical Observation of Rocuronium Used for Endotracheal Intubation

Objective To observe the indications and adverse reactions of rocuronium used for endotracheal intubation in patients of neurosurgical operation.Methods 470 neurosurgical patients, ASA Ⅰ～Ⅲ, were induced with fentanyl 2 μg/kg, rocuronium 0.6 mg/kg and propofol 2 mg/kg after the airway condition was evaluated with Mallampatti classification. The exposure of the glottis was evaluated with Cormack-Lehane classification. The adverse reactions of rocuronium and the patients' motions were recorded during tracheal intubation.Results Intubation was successfully performed once in 94.7% patients, twice in 4.0% patients, and three times in 1.3% patients. The occurrence of adverse reactions was 13.4%. 6.4% patients had motion response during intubation.Conclusion Rocuronium can be safely applied in neurosurgery. In addition to Mallampatti classification, Cormack-Lehane classification increases and the occurrence of difficult intubation rises.