经气管镜超声引导针吸活检术持续输注琥珀胆碱的可行性与安全性

目的:探讨经气管镜超声引导针吸活检术(endobronchial ultrasound-guided transbronchial needle aspiration,EBUS-TB-NA)持续输注琥珀胆碱的可行性和安全性。方法:择期行EBUS-TBNA的患者73例,静脉注射咪达唑仑0.04mg/kg、芬太尼2μg/kg;异丙酚靶控输注,设定其血浆浓度为3μg/mL;琥珀胆碱0.5mg/kg静脉注射后,以3mg/(kg.h)注射。全麻诱导1min后置入喉罩,连接麻醉机行机械通气。监测并记录患者的血压(BP)、心率(HR)和脉搏氧饱和度(SpO2);记录术中和术后患者有无呛咳及心血管系统不良反应等并发症;记录琥珀胆碱的用量、手术时间和手术结束至拔除喉罩的时间。手术结束时抽取静脉血,检测血清钾离子(K+)浓度。结果:所有患者术中均无呛咳及窦性心动过缓发生,术后能够快速恢复自主呼吸,拔除喉罩后无低氧血症发生;琥珀胆碱的用量为(2.08±1.73)mg/kg;术后血K+浓度与术前比较无显著差异(P>0.05)。结论:全麻EBUS-TBNA时持续输注琥珀胆碱是安全、有效的。

Feasibility of Continuous Succinylcholine Infusion for General Anesthesia in Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration

Objeetive..To evaluate the applicability and safety of continuous succinyleholine infusion for general anesthesia in endobronchial ultrasound-guided transbronchial needle aspiration （EBUS-TBNA）. Methods：Seventy-three patients were sched- uled to undergo EBUS-TBNA. Anesthesia was induced with midazolam 0.04 mg/kg, fentanyl 2 μg/kg, target controlled infu- sion （TCI） propofol 3 μg/mL, succinylcholine 0.5 mg/kg and maintained with 3 mg/kg/h. Laryngeal mask was used at 1 min after intravenous succinylcholine. The succinylcholine consumption, surgical time and the extubation time were recorded. Ser- um potassium concentration was measured after EBUS-TBNA. Results： All patients have finished EBUS-TBNA successfully without any serious complications. And the spontaneous respiration recovered rapidly after the end of EBU-TBNA. The succi- nylcholine consumption was （2.08 ± 1.73）mg/kg. There was no significant difference in the serum potassium levels before and after the operation （P〉0.05）. Conclusions.. EBUS-TBNA can be safely performed under continuous suecinyleholine infusion for general anesthesia.