顺式阿曲库铵在小儿全身麻醉中对气道功能的影响

目的:比较顺式阿曲库铵和阿曲库铵在小儿全麻中对气道功能的影响。方法:选取72名3-9岁患儿,男42例,女30例,采用随机表法将其分为观察组和对照组,每组36例。两组麻醉诱导都采用异丙酚,芬太尼,咪达唑仑。观察组使用顺式阿曲库铵0.15mg/kg,对照组组阿曲库铵0.5 mg/kg,比较两组小儿在插管后5 min、10 min、15 min、20 min患儿P_(ET)CO_2、P-PEAK、听诊呼吸音(粗、细湿啰音)、SPO_2变化四项指标来研究顺式阿曲库铵和阿曲库铵对呼吸系统的影响。结果:观察组注药后5 min、10 min、15 min、20 min时间点P_(ET)CO_2,P-PEAK变化趋势不明显,听诊呼吸音、SPO_2无明显变化(P0.05)。对照组在注药后的4个时间段P_(ET)CO_2、P-PEAK、听诊呼吸音、SPO_2有显著变化,随时间延长,P_(ET)CO_2,P-PEAK有明显增高,SPO_2逐渐下降情况(P0.05)。观察组和对照组相比,5 min、10 min、15 min、20 min各时间点观察组SPO_2高于对照组,PETCO_2、P-PEAK明显低于对照组,啰音发生的概率低于对照组,各时间点各项指标比较差异有统计学意义(P0.05)。结论:顺式阿曲库铵术中对小儿气道功能影响较小,肌松作用理想,可广泛应用于小儿临床麻醉。

Influence on Airway Function of Cis Atracuriumduring General Anesthesiain Pediatric Surgery

Objective:To compare the influence of cis atracurium and atracurium on the airway function in pediatric anesthesia.Methods:A total of 72 patients (42 male and 30 female) were divided into the observation group and control group randomly, 36 cases ineach group. Anesthesia induction adopted propofol, fentanyl and midazolamin two groups. The cis atracurium (0.15 mg/kg) was used inobservation group while atracurium (0.5 mg/kg) was used in control group. Then comparison of the PETCO2, P-PEAK, auscultation breathsounds, SPO2were conducted between two groups of children at 5, 10, 15, 20 min after intubation on the respiratory system.Results:Thechanging trend of PETCO2 and P-PEAK was not obvious in observation group at 5, 10, 15, 20 min after intubation, and the auscultationbreath sounds and SPO2 also had no significant change (P>0.05). However, PETCO2, P-PEAK, auscultation breath sounds and SPO2 hadgreat changes at 5, 10, 15, 20 min after intubation in control group (P<0.05). As time increasing, the PETCO2 and P-PEAK increasedmarkedly, and SPO2 declined gradually in the control group (P <0.05). At each time point, the SPO2 in observation group was higher thanin the control group; PETCO2, P-PEAK and the rale occurrence rate in observation group were significantly lower than in the controlgroup, and the differences were statistically significant (P<0.05).Conclusion:The cis atracurium has less impact on the airway functionand ideal muscle relaxant effect, so it could be widely used in clinical general anesthesia.