文章摘要
温晶,张晓东,尚颖.Concert-1闭环肌松注射系统输注不同剂量米库氯铵在耳鼻喉手术中的疗效及安全性比较[J].安徽医药,2021,25(10):2013-2017.
Concert-1闭环肌松注射系统输注不同剂量米库氯铵在耳鼻喉手术中的疗效及安全性比较
Comparison of efficacy and safety of concert-1 closed loop muscle relaxation injection system infused with different doses of mivacurium in ear-nose-throat surgery
  
DOI:10.3969/j.issn.1009-6469.2021.10.024
中文关键词: 米库氯铵  耳鼻喉外科手术  肌松弛  Concert-1闭环肌松注射系统  安全性
英文关键词: Mivacurium chloride  Otorhinolaryngologic surgical procedures  Muscle relaxation  Concert-1 closed loop muscle relaxation injection system  Safety
基金项目:保定市科技支撑计划项目( 17ZF011)
作者单位
温晶 保定市第二医院麻醉科河北保定 071000 
张晓东 保定市第二医院麻醉科河北保定 071000 
尚颖 保定市第二医院麻醉科河北保定 071000 
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中文摘要:
      目的探究 Concert-1闭环肌松注射系统输注不同剂量米库氯铵在耳鼻喉手术中的疗效及安全性差异。方法回顾分析 2018年 1月至 2019年 6月在保定市第二医院行全麻下耳鼻喉手术的病人临床资料,根据治疗剂量分为高剂量组( 0.25 mg/ kg)、常规剂量组( 0.20 mg/kg)及低剂量组( 0.15 mg/kg),各 40例,并应用 Concert-1闭环肌松注射系统进行对应剂量米库氯铵注射。记录两组病人肌松起效时间、恢复时间,米库氯铵注射前后血流动力学变化、血液组胺浓度变化及两组病人不良反应发生情况。结果三组病人肌松起效时间比较具有显著差异,其中高剂量组肌颤搐抑制达 75%(ThD75)(135.25±15.61)s、肌颤搐抑制达 90%(ThD90)(150.25±21.54)s及肌颤搐抑制达最大阻滞程度时间( ThDmax)(168.16±19.78)s均最快,低剂量组 ThD75
英文摘要:
      Objective To explore the differences in efficacy and safety of Concert-1 closed loop muscle relaxation injection system infused with different doses of mivacurium in ear-nose-throat (ENT) surgery.Methods Clinical data of patients who underwent ENTsurgery under general anesthesia in The No.2 Hospital of Baoding from January 2018 to June 2019 were retrospectively analyzed. Patients were randomly assigned into high-dose group (0.25 mg/kg), conventional dose group (0.20 mg/kg) and low-dose group (0.15 mg/ kg) by random number table method, with 40 cases in each group, and the Concert-1 closed loop muscle relaxation injection system wasused for the injections of corresponding doses of mivacurium. The onset time of muscle relaxation, recovery time, hemodynamic changes, changes in blood histamine concentration, and adverse reactions of the two groups of patients before and after injection were recorded.Results There was a significant difference in the onset time of muscle relaxation among the three groups. ThD75 (135.25±15.61) s,ThD90 (150.25±21.54) s, and ThDmax (168.16±19.78) s were the quickest in the high-dose group, and ThD75 (158.71±17.24) s, ThD90 (179.67±24.67) s and ThDmax (190.18±21.13) s were the slowest in the low-dose group. The differences were statistically significant (F=20.915, 116.185, 12.015, respectively; all P<0.001). There were no significant differences in the recovery time of ThR25, RI, and TOFr90 among the three groups (P>0.05). Five minutes after mivacurium injection, systolic blood pressure (SBP) (113.79±23.31) mmHg in the high-dose group significantly decreased, and heart rate (HR) (96.47±11.97) times/min significantly increased. In comparison with the SBP (126.67±23.97) mmHg, HR (84.36±10.59) times/min in the conventional dose group and the SBP (98.72±0.84)mmHg, HR (82.49±10.54) times/min in the low dose group, the differences were statistically significant ( F=5.818, 18.804; both P< 0.05). Five minutes after the injection, the blood histamine concentrations of the three groups all increased significantly, which showedhighest in high dose group and lowest in low dose group [(1.57±0.26) ng/mL vs. (1.34±0.25) ng/mL vs. (1.07±0.21) ng/mL]. The differ ences among the groups were statistically significant (P<0.05). There were no statistically significant differences in the dosage of mivacurium, total operation time, and total incidence of adverse reactions among the three groups (P>0.05).Conclusions Both 0.20 mg/kgand 0.25 mg/kg mivacurium can provide satisfactory muscle relaxation in ENT surgery, and the safety is comparable. Appropriate dosecan be selected clinically according to patients' body tolerance.
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