闭环肌松注射系统在腰椎手术中的应用OA

Objective To explore the clinical effect and safety of closed loop muscle relaxant infusion system(CLMRIS-1),muscle relaxant monitor,and empirical muscle relaxant administration in lumbar surgery under general anesthesia.Meth-ods A total of 150 patients who underwent lumbar surgery under intubation general anesthesia from July 2022 to December 2023 in Hechi Third People's Hospital,Guangxi Zhuang Autonomous Region were selected as the research objects.According to the random number table method,they were divided into group A(50 cases),group B(50 cases)and group C(50 cases).Group A were treated with CLMRIS-1,group B were monitored with muscle relaxant,and group C were treated with empirical muscle relaxant.The airway peak pressure(PPeak)and airway plateau pressure(PPlat)were compared among the three groups of patients at 3 min(T 1),30 min(T2),60 min(T3)after intubation,and at the end of skin closure(T4).Percu-taneous arterial oxygen saturation(SpO2)was compared at the time of tracheal tube removal(T5),at 10 min(T6)and 30 min(T7)after extubation.The following parameters were also compared:tracheal intubation time,time to return of spontaneous breathing,extubation time,time to discharge from the post-anesthesia care unit,the surgeon's satisfaction with intraoperative muscle relaxation,the total dosage of muscle relaxants administered,the occurrence of body movements during intubation and surgery,the dosage of neostigmine used during the recovery period,and the incidence of adverse reac-tions after extubation.Results At T2,T3,and T4,the PPlat and PPeak in all three groups were higher than those at T1 in the same group,and the differences were statistically significant(P＜0.05).At T3 and T4,the PPlat and PPeak in all three groups were higher than those at T2 in the same group,and the differences were statistically significant(P＜0.05).There were no statistically significant differences in PPlat and PPeak among the three groups at the same time points(P＞0.05).There was statistically significant difference in patient satisfaction among the three groups(P＜0.05),specifically,the satisfaction in group A was higher than that in group C,and the difference was statistically significant(P＜0.017).There were no statisti-cally significant differences in SpO2 between the two groups at T5,T6,and T7(P＞0.05).There was statistically significant difference in the total dosage of rocuronium among the three groups(P＜0.05),specifically,the total dosage of rocuronium in group C was higher than that in group A,and the difference was statistically significant(P＜0.05).There were no statistically significant differences among the three groups in the total dosage of reversal agents or the total incidence of adverse reactions(P＞0.05).There were no statistically significant differences among the three groups in terms of tracheal intubation time,time to return of spontaneous breathing,extubation time,or time to discharge from the post-anesthesia care unit(P＞0.05).Conclusion In lumbar surgery under general anesthesia,CLMRIS-1 is equivalent to muscle relaxant monitor in maintaining the effect of muscle relaxant during surgery,but compared with empirical muscle relaxant administration,CLMRIS-1 can significantly improve surgeons' satisfaction with muscle relaxant status,reduce the total dosage of muscle relaxants,without increasing the incidence of adverse reactions,and has no negative impact on patients' airway pressure,vital signs and recovery time,indicating that CLMRIS-1 is a more optimized and safe muscle relaxant management strategy.