老年腹腔镜胃肠肿瘤手术间断静注与持续输注顺阿曲库铵的药效学比较-麻醉学专业论文.docxVIP

上海交通大学医学院 2011 级硕士毕业论文 中文摘要 老年腹腔镜胃肠肿瘤手术间断静注与持续输注 顺阿曲库铵的药效学比较 目的：比较单次静注与持续输注顺阿曲库铵对老年病人腹腔镜胃肠肿瘤手术肌 松药效应的影响。 方法：选择全麻腹腔镜胃肠肿瘤手术的老年病人 60 例，ASAⅠ－Ⅱ级，随机分 成间断给药组（Ⅰ组）和持续给药组（Ⅱ组），每组 30 例。麻醉诱导后Ⅰ组根 据手术需要间断静注，Ⅱ组采用微量泵持续输注，用 TOF Watch SX 肌松监测 仪,观测术中肌松药用量情况，当 T1 恢复到 10％时，I 组追加另一剂量的顺阿 曲库铵,II 组调整输注速率。计算停药后 TOF 恢复到 75%,90%时间和从 25%－75% 恢复时间（恢复指数，RI）。计算间断给药组给药次数、持续给药组平均给药 速度和两组术中顺阿曲库铵总用量。 结果 1 两组给药方式均能满足术中肌松需要，Ⅱ组顺阿曲库铵用量小于 I 组 （ｐ＜0.05） 2 Ⅱ组停药后至 TOF 恢复到 70%和 90%时间短于 I 组,Ⅱ组恢复指数较 I 组快（ｐ＜0.05） 结论：静脉持续给药能减少老年病人腹腔镜胃肠肿瘤手术顺阿曲库铵用药量， 有利于手术后肌松作用的消退。 【关键词】 顺阿曲库铵，单次静注和持续输注,老年病人腹腔镜胃肠手术, 神 经肌肉阻滞 1 上海交通大学医学院 上海交通大学医学院 2011 级硕士毕业论文 PAGE PAGE 10 Abstract Comparison of the intermittent injection and the continuous infusion of cis-atracurium in laparoscopic gastrointestinal tumor surgery of elderly patients. Objective To compare the influence of pharmacodynemics between intermittent injection and continuous infusion of cis-atracurium in laparoscopic gastrointestinal tumor surgery of elderly patients. Methods 60 elderly patients (ASA Ⅰ－Ⅱ ) undergoing laparoscopic gastrointestinal tumor surgery with general anesthesia were allocated into group Ⅰand group II randomly. In groupⅠcis-atracurium was administered intermittently, while in group II cis-atracurium was infused continuously. The neuromuscular block effect was monitored using TOF Watch SX Monitoring during operation. When T1 recovered to 10% after induction, another dose of cis-atracurium was added for Group Ⅰ and the infusion rate for the continuous infusion for Group II was adjusted. The total dose in the two groups, the added dose times in intermittent injection group, and the average delivery rate of cis-atracurium in the continuous infusion group were calculated. Recovery time of TOF to 75% and 90% and the recovery index were recorded Results The consumption amount of cis-atracurium in group II was less than that of group I（ｐ＜0.05） In group II, the recovery time of TOF to the level of 70% or 90% and the recover index was more rapi