靶控输注与闭环式肌松注射阿曲库铵效果比较

目的：对靶控输注与闭环式肌松注射2种方式注射阿曲库铵的效果进行比较，探讨二者优缺点。方法：全凭静脉麻醉下行择期开腹手术病人75例，随机分为靶控输注组（T组，n=39），闭环式肌松注射组（C组，n=36）。T组采用靶控方式注射阿曲库铵，诱导时靶控浓度设定为5mg／L，气管插管后调整为1mg／L，术中根据肌松需求调节靶控浓度。c组采用闭环式肌松注射系统注射阿曲库铵，诱导量为0．5mg／kg，维持速度为2．5I,~g／kg／min，增药条件为T1／Tc（4个成串刺激中，第1次肌颤与基础值之比）〉10％，增药速度为10~g／kg／min，记录2组肌松起效时间、恢复指数、停药至拔管时间、用药量、术中肌松不足出现次数、各阶段平均动脉压、心率、呼吸频率、spO2。2组均不使用拮抗剂，术毕待T1／Tc恢复至90％后拔管。结果：2组一般资料，各阶段平均动脉压、心率、SpO：比较无统计学意义（P〉0．05），阿曲库铵起效时间、插管条件比较无统计学意义（P〉0．05），与T组相比，C组恢复指数，拔管时间缩短，用药量增大，肌松不足出现次数减少（P〈0．05）；结论：靶控输注与闭环式肌松注射两种方式注射均能安全应用于临床，但闭环式肌松注射恢复更快，更合理，操作数更少。

Efficacy comparison of atracurium through target control infusion and continuous close-loop muscle relaxant injection

Objective： To compare the efficacy of atracurium administered through： target control infusion and closed-loop muscle relaxant injection. Methods： 75 patients undergoing laparotomy under total intravenous anesthesia were randomly divided into two groups： Group T（n=39） received atracurium by target control infusion. The target concentration during induction was set at 5 mg/L,after trachea cannula at 1 rag/L, and during opera- kg/min when T1/Tc 〉 10%. The onset time,recovery index, the time from stopping injection to extubation, dosages ,frequenee of dissatisfying muscle relaxation, mean arterial pressure, heart rate, respiratory rate, and SpO2 in the two groups were compared. No antagonist was used in both groups. It was the time for extubation when T1/ Tc recovered to 90%. Results： There were no statistical differences in onset time, mean arterial pressure, heart rate ,respiratory rate, and SpO2 between the two groups （P 〉 0.05）. Compared with group T, the recovery index, the time form stopping injection to extubation of group C was shorter, dosages larger and frequence of dissatisfy- ing muscle relaxation less （P 〈 0.05）. Conclusion： Both target control infusion and close-loop muscle relaxant injection can be safely used in clinical practice, but the latter makes patients recover faster and anesthetist man- age easier.