顺苯磺酸阿曲库铵和维库溴铵对甲状腺手术肌电图影响的比较.pdf

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1、l床麻醉学杂志2013年4月第29卷第4期JClinAnesthesiol，April2013，Vo1．29，No．4·365·．临床研究．顺苯磺酸阿曲库铵和维库溴铵对甲状腺手术肌电图影响的比较曹建方谢红陶苏蔚乔世刚朱旬王琛【摘要】目的观察2倍ED9s剂量的顺苯磺酸阿曲库铵和维库溴铵在甲状腺手术全麻气管插管时肌松效果及对肌电图(electromyography，EMG)的影响。方法择期甲状腺手术患者112例，随机均分为两组，分别用0．15mg／kg顺苯磺酸阿曲库铵(A组)或0．10mg／kg维库溴铵(V组)伍用芬太尼和丙泊酚行

2、全麻诱导气管插管。采用Helbo—Hansen修正评分系统评价插管条件。记录患者拇内收肌抽搐达07oTw所需时间。监测静注肌松药后30~70minEMG振幅。结果两组插管条件、拇内收肌抽搐达OTW所需时间比较差异无统计学意义。静注肌松药后3O、35min，A组EMG振幅阳性有效率明显高于V组(P

3、cisatracuriumandvecuroniumonneuromonitoringduringthyroidsurgeryC40Jian-fang，XIEHong，O“一wei，QIAO跏一，Xun，WANGChen．DepartmentofAnesthesiology，SecondHospita1AffiliatedtoSoochowUniversity，Suzhou215004，ChinaCorrespondingauthor：XIEHong，Email：caojianfang1972@126．corn[Abstrac

4、t]ObjectiveTocomparetheeffectofbothcisatracuriumandvecuroniumonneuromonitoringduringthyroidsurgery．MethodsAtotalof112patientswererandomizedtoreceive2timesED95dose0．15mg／kgofcisatracurium0．15mg／kg(groupA)orvecuronium0．10mg／kg(groupV)with56caseseachtofacilitateendotra

5、chealtubeinsertionandelectromyography(EMG)．Evokedpotentialswereobtainedevery5minbystimulatingthevagusorrecurrentlaryngealnervebetweentheperiodof30and70minafteradministrationofcisatracuriumorvecuroniurn．Thetrachealintubatingconditions，thetimerequiredforeachgroupwitha

6、dductorpollicismuscletwitching0andthemagnitudeofevokedpotentialsateachtimepointwerecomparedbetweenthetWOgroups．Accelerometry(twitch)wasusedtomonitorthequantitativedegreeofneuromusculartransmissionattheadductorpollicismuscle．ResultsNosignificantdifferencewasobservedb

7、etweenthetwogroupsintheoveral1intubationconditions．At30and35minafteradministrationofcisatracuriumorvecuronium，thetwitchinbothgroupswere0，butthedifferentrateofpositiveEMGresponsewasconsiderablebetweenthetwogroups(Pd0．05)．ThemeanamplitudeofEMGfromthetimepointof30to7Om

8、inwasgreaterinthegroupAthanthecomparison．ConclusionBothcisatracuriumandvecuroniumat2timesE【)95dosescanbeappliedtotrachealintubationforintr