目的 探讨内镜下逆行胰胆管造影术(ERCP)全身麻醉术中应用舒芬太尼复合小剂量罗库溴铵的肌松作用及安全性.方法 选取 2019 年9 月至2022 年12 月于上海交通大学医学院苏州九龙医院接受ERCP的100 例患者作为研究对象,随机分为观察组(n=50,接受舒芬太尼+小剂量罗库溴铵麻醉)和对照组(n=50,接受舒芬太尼+琥珀胆碱麻醉).比较两组患者气管插管状态,入室后(T0)、内镜置入咽部(T1)、操作稳定时(T2)、操作结束时(T3)的心率(HR)、平均动脉压(MAP)、血氧饱和度(SPO2)、气道峰压(Ppeak),记录两组患者不良反应发生情况、术后恢复情况.结果 观察组气管插管优良率与对照组比较差异无统计学意义(P＞0.05);与T0 时刻相比,T1～T3 时刻两组心率、MAP均降低(P＜0.05),且观察组低于对照组(P＜0.05),不同时间点两组SPO2 水平比较差异无统计学意义(P＞0.05),T1～T3 时刻,观察组Ppeak低于对照组(P＜0.05);观察组不良反应发生率为 4.00%显著低于对照组的 20.00%(P＜0.05);观察组睁眼时间、麻醉恢复室(PACU)停留时间以及拔管时间短于对照组(P＜0.05).结论 对ERCP患者联合应用舒芬太尼和小剂量罗库溴铵效果值得肯定,有助于改善围术期应激反应,减少不良反应发生,同时还可以加快患者术后康复进程.
Objective To explore the muscle release effect and safety of sufentanil combined with low dose rocuronium in Endoscopic retrograde cholangiopancreatography(ERCP)performed under general anesthesia.Methods A total of 100 patients receiving ERCP in Suzhou Jiulong Hospital,Shanghai Jiao Tong University School of Medicine from September 2019 to December 2022 were selected as the study objects,and randomly divided into observation group(n=50,receiving sufentanil + low-dose rocuronium bromide anesthesia)and control group(n=50,receiving sufentanil + succincholine anesthesia).The status of endotracheal intubation,heart rate(HR),mean arterial pressure(MAP),blood oxygen saturation(SPO2)and airway peak pressure(Ppeak)after entry(T0),endoscopic pharynx placement(T1),stable operation(T2),and the end of operation(T3)of patients in the two groups were compared,and adverse reactions and postoperative recovery of patients in the two groups were recorded.Results There was no significant difference in the excellent rate of tracheal intubation between observation group and control group(P＞0.05).Compared with T0 moments,heart rate and MAP of both groups were decreased at T1～T3 moments(P＜0.05),and the observation group was lower than the control group(P＜0.05).There was no significant difference in SPO2 level between the two groups at different time points(P＞0.05).Ppeak of the observation group was lower than that of the control group at T1～T3 moments(P＜0.05).The incidence of adverse reactions in observation group(4.00%)was significantly lower than that in control group(20.00%)(P＜0.05).Eye opening time,PACU residence time and extubation time in observation group were shorter than those in control group(P＜0.05).Conclusion The combined application of sufentanil and low-dose rocuronium bromide in ERCP patients has a positive effect,which can help to improve the perioperative stress reaction of patients,reduce the incidence of adverse reactions in patients,and accelerate the postoperative rehabilitation process of patients.
吕光;陈鹏;赵宇浩;尹述洲
上海交通大学医学院苏州九龙医院麻醉科,江苏苏州 215000
临床医学
舒芬太尼;罗库溴铵;内镜下逆行胰胆管造影术;全身麻醉;应激反应;苏醒时间
Sufentanil;Rocuronium bromide;Endoscopic retrograde cholangiopancreatography;General anesthesia;Stress response;Awakening time
《中国药物经济学》 2024 (004)
67-71 / 5
10.12010/j.issn.1673-5846.2024.04.012
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