【作者】 白丽萍；

【导师】 陈丽；

【作者基本信息】 山西医科大学 ， 麻醉学， 2008， 硕士

【摘要】 目的观察顺式阿曲库铵的肌松效应。方法选择ASAⅠ～Ⅱ级择期腹部手术病人60例,随机分为顺式阿曲库铵A组（2min）、顺式阿曲库铵B组（3min）和顺式阿曲库铵C组（4min）,每组各20例。麻醉诱导依次静脉注射咪达唑仑0.05mg·kg^-1、枸橼酸芬太尼2μg·kg^-1和依托咪酯0.3mg·kg^-1,待患者意识消失后注入肌松药顺式阿曲库铵0.15mg·kg^-1（注药时间为5～10秒）。三组在分别给予肌松药后2min、3min和4min时行经口气管内插管。观察放置喉镜的难易程度及各时点能否顺利进行气管插管,记录诱导前（T₁）、诱导后（T₂）、气管插管后1min（T₃）、插管后3min（T₄）、插管后5min（T₅）、插管后10min（T₆）、插管后15min（T₇）的收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）和心率（HR）,以及术中不良反应的发生情况。结果①与A组相比,B组和C组的插管条件优秀率较高（P＜0.05）;B组与C组比较无显著性差异（P＞0.05）;②三组患者在不同时段自身比较,在T₃（气管插管后1min）时刻SBP、DBP、MAP和HR与麻醉前比较差异有显著性（P＜0.05）,其余时刻各值比较差异无显著性;三组组间比较差异无显著性（P＞0.05）;③全麻诱导期间不良反应的发生率A组、B组和C组比较差异无显著性（P＞0.05）。结论在平衡麻醉时静注顺式阿曲库铵0.15mg·kg^-1(3×ED₉₅)在3min时就可达到良好的插管条件,与同等强度剂量的阿曲库铵相比,前者起效较慢,为中时效非去极化肌松药。无组胺释放,无心血管不良反应,血流动力学稳定。更多还原

【Abstract】 Objective To observe the neuromuscular blockade effects and side effects of cisatracurium on rapid endotracheal intubation.Methods Sixty patients were randomized to three groups（n=20）:A group（cisatracurium, 2min）,B group（cisatracurium,3min）,C group（cisatracurium,4min）.All patients were anesthetized with intravenously injection of midazolam(0.05mg·kg^-1),fentanyl(2μg·kg^-1)、etomidate(0.3mg·kg^-1) and cisatracurium(0.15mg·kg^-1).Then the haemodynamical changes before and 1～15min after administration of the relaxant were recorded,the neuromuscular blockade and side effects of groups were also observed.Results The intubation situationof B、C groups was better than A group.The B,C groups had no significant differences（P＞0.05）.The haemodynamical changes had no significant differences（P＞0.05）.But the Bp and HR after lmin of intubation were higher than ante-intubation within group.The side effects had no significant differences in 3 groups （P＞0.05）.Conclusion The intubation situation can achieve best at 3min after administration of the cisatracurium(0.15mg·kg^-1).Cisatracurium does not affect plasma histamine concentration and haemodynamics.It can be safely used in the rapid endotracheal intubation of general anesthesia with satisfactory neuromuscular blocking effects.更多还原