顺式阿曲库铵和阿曲库铵用于全麻气管插管腹腔镜胆囊切除术中效果比较

目的 探讨顺式阿曲库铵和阿曲库铵在全麻气管插管腹腔镜胆囊切除术中的肌松效果及不良反应发生情况.方法 回顾性分析2014年2月-2015年10月行全麻气管插管的腹腔镜胆囊切除患者120例的临床资料,根据用药情况分为研究组68例和对照组52例,研究组给予顺式阿曲库铵,对照组给予阿曲库铵.观察2组气管插管完成率、气管插管条件、插管时声门暴露程度及肌松药起效时间,记录诱导前(T1)、插管后1 min(T2)、插管后15 min(T3)时血氧饱和度(SpO2)及心率变化情况,分析2组不良反应发生情况.结果 2组气管插管完成率、气管插管条件及插管时声门暴露程度良好率比较差异无统计学意义(P＞0.05).研究组起效时间长于对照组,总不良反应发生率低于对照组(P＜0.05).2组T1-3时点SpO2、心率组内及组间比较差异均无统计学意义(P＞0.05).结论 顺式阿曲库铵和阿曲库铵均可在全麻气管插管腹腔镜胆囊切除术中发挥理想的肌松效果,但顺式阿曲库铵安全性更高.

Effect Comparison on Cisatracurium and Atracurium in Application of Laparoscopic Cholecystectomy under General Anesthesia by Tracheal Intubation

Objective To investigate muscle relaxation effects and incidence rates of adverse reactions of Cisatracurium and Atracurium in application of laparoscopic cholecystectomy under general anesthesia by tracheal intubation.Methods Clinical data of 120 patients undergoing laparoscopic cholecystectomy under general anesthesia by tracheal intubation between February 2014 and October 2015 were retrospectively analyzed.The patients were divided into study group (using Cisatracurium,n--68) and control group (using Atracurium,n =52) according to the use of drugs.In two groups,completion rates of tracheal intubation,conditions of tracheal intubation,degree of glottic exposure during tracheal intubation and onset time of muscle relaxants were observed,and level changes of arterial oxygen saturation (SpO2)and heart rate (HR) were recorded before induction (T1),1 min (T2) and 15 min (T3) after intubation were recorded;incidence rates of adverse reactions were analyzed.Results There were no significant differences in completion rate of tracheal intubation,conditions of tracheal intubation,excellent and good rate of glottic exposure between the two groups (P ＞ 0.05).In study group,the onset time of muscle relaxants was significantly longer (P ＜ 0.05),and incidence rate of adverse reactions was lower than those in control group (P ＜ 0.05).During T1-3,SpO2 and heart rate showed no significant differences within group and between groups (P ＞ 0.05).Conclusion Both of Cisatracurium and Atracurium play ideal muscle relaxant effects in laparoscopic cholecystectomy under general anesthesia by tracheal intubation,but Cisatracurium is safer.