罗库溴铵靶控输注用于老年患者腹腔镜手术效果观察

目的探讨罗库溴铵靶控输注(TCI)用于老年患者腹腔镜手术的效果。方法择期行腹腔镜手术老年患者84例,美国麻醉医师协会(对患者的病情和体格情况评估标准)(ASA)Ⅱ级,年龄65～83岁,随机分为A、B、C 3组,每组28例,将A、B、C 3组诱导插管时静脉注射罗库溴铵0.6mg/kg,术中维持效应室靶浓度分别为0.6、0.8、1.0mg/L。观察各组诱导插管起效时间、气管插管条件、术中骨骼肌松弛条件和术后骨骼肌松弛恢复情况。结果 A、B、C 3组均可顺利完成气管插管,术中A组骨骼肌松弛条件满意率低于B组和C组;与B组比较,C组罗库溴铵用药量大,术中肌肉阻滞程度较深,术后恢复时间延长,差异有统计学意义(P<0.05)。结论老年患者腹腔镜手术诱导插管时以罗库溴铵0.6mg/kg进行骨骼肌松弛维持,术中效应室靶浓度维持在0.8mg/L,可以实现诱导插管顺利、术中骨骼肌松弛满意和术毕迅速恢复。

Efficacy of rocuronium for target controlled infusion system in geriatric patients operation on laparoscopic surgery

Objective To investigate the efficacy of rocuronium for target controlled infusion in geriatric patients operation on laparoscopic surgery.Methods 84 ASA grade Ⅱ and 65-83 years aged geriatric patients scheduled for operation on laparoscopic surgery under general anesthesia were randomized into A,B,C three groups,with 28 patients in each group.Rocuronium for intubation was 0.6 mg/kg in each group,and the target effective site concentration（Ce） during operation were 0.6 mg/L,0.8 mg/L,and 1.0 mg/L in A,B and C group,respectively.Results Successful intubation condition was obtained in three groups.Neuromuscular block during operation was satisfactory in group B and C,but not in group A.The rocuronium consumption,muscle relaxation during surgery and recovery time to 25% of T1 of C group were more than those of group B（P0.05）.Conclusion The dosage regimen of group B（0.6 mg/kg of rocuronium for maintaining skeletal muscle relaxation during intubation,and 0.8 mg/L of the target effective site concentration during operation）is more suitable for geriatric patients operation on laparoscopic surgery.