米库氯铵用于膀胱镜电切术治疗膀胱癌麻醉的效果分析

目的探讨米库氯铵用于膀胱镜电切治疗膀胱癌麻醉中的临床效果。方法将74例择期行膀胱镜电切术的患者随机分成观察组和对照组，每组各37例，麻醉诱导采用先给予肌松药的方法，分别给予0．25mg／kg米库氯胺和0．15mg／kg维库溴铵进行静脉泵注，利用肌松监测仪进行监测，术中分别采用7州（kg·min）米库氯胺和1～2μg（kg·min）维库溴铵进行维持。记录两组的手术时间和肌松药用量，注射肌松药前后心率和平均动脉压变化情况。比较两组的肌松药显效时间、起效时间、恢复指数和拔管时间。结果两组的手术时间和肌松药用量差异均无统计学意义（D0．05），肌松药使用前后，两组的心率和平均动脉压差异均无统计学意义（P〉0．05）；观察组的肌松药显效时间为（1．7±0．5）min、起效时间为（2．7±1．1）min，均短于对照组（P〈0．05），对照组的恢复指数时间为（15．2±3．8）min、拔管时间为（38．7±8．9）min，均长于观察组（P〈0．05）。结论膀胱镜电切治疗膀胱癌麻醉中应用米库氯铵具有起效快、肌松效果好、术后易清除等特点，值得临床推广应用。

Effect analysis of mivacurium chloride used,for anesthesia on electrical resection with cystoscope in the treatment of bladder cancer V4 N~ IVpi

Objective To explore the clinical effect of mivacurium chloride used for anesthesia on electrical resection with eystoseope in the treatment of bladder cancer. Methods 74 patients undergone electrical resections with cystoscope were evenly and randomly divided into the observation group and the control group.Anesthesia induction was firstly provided with muscle relaxant.To be specific,0.25 mg/kg mivacurium chloride and 0.15 mg/kg vecuronium bromide was injected through venous pump separately.The process was monitored by muscle relaxant monitor. During surgery,7 μg/（kg· min） mivacurium chloride and 1-2 μg/（kg·min） vecuronium bromide were injected for maintenance in each own group.The operation time,dosage of muscle relaxant,heart rate and mean arterial pressure before and after injecting muscle relaxant were recorded in both groups.Time of muscle relaxant displaying effect,taking effect,recovery index,and drawing tube were compared in the two groups. Results There was no statistical difference of operation time and dosage of muscle relaxant in both groups （P〉0.05）.Heart rate and mean arterial pressure in both groups didn＇t display significant difference before and after using muscle relaxant （P〉0.05）.Time of muscle relaxant displaying effect and taking effect （1.7±0.5）min and （2.7±1.1）min respectively] were shorter than those in the control group （P〈0.05）.Time of recovery index and drawing tube in the control group （15.2±3.8） min and （38.7±8.9） min respectively]] were longer than those in the observation group （P〈0.05）. Conclusion In the treatment of bladder cancer by electrical resection with eystoseope,mivacurium chloride used for anesthesia has advantages of quick effect,good effect of muscle relaxant, and easy clearance after surgery,which is worthy of expansion and application in clinic.