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插管的难易程度:一项比较两种剂量的罗库溴铵用于气管插管的随机双盲研究。

Ease of intubation: A randomized, double-blind study to compare two doses of rocuronium bromide for endotracheal intubation.

作者信息

Shukla Aparna, Misra Shilpi

机构信息

Department of Anesthesia, Integral Institute of Medical Sciences and Research, Lucknow, Uttar Pradesh, India.

出版信息

Anesth Essays Res. 2016 Sep-Dec;10(3):512-515. doi: 10.4103/0259-1162.179308.

Abstract

CONTEXT

Clinical need for a nondepolarizing agent with a rapid onset time and a brief duration of action has led to the development of rocuronium bromide.

AIMS

The aim of this study was to evaluate optimal dose of rocuronium bromide for intubation and to compare the onset time, duration of action, intubating conditions, and hemodynamic effects of two doses of rocuronium bromide.

SETTINGS AND DESIGN

A prospective, randomized, double-blind study.

MATERIALS AND METHODS

All the patients were divided in a randomized, double-blind fashion into two groups of twenty patients each. Group I patients received rocuronium bromide 0.6 mg/kg intravenously and intubated at 60 s, Group II patients received rocuronium bromide 0.9 mg/kg and intubated at 60 s. The neuromuscular block was assessed using single twitch stimulation of 0.1 Hz at adductor pollicis muscle of hand at every 10 s.

STATISTICAL ANALYSIS USED

The results were compiled and analyzed statistically using Chi-square test for qualitative data and Student's -test for quantitative data.

RESULTS

Time of onset was significantly shorter ( < 0.01) and duration of action was prolonged ( < 0.001) for Group II as compared to Group I. The intubating conditions were (excellent + good) in 100% patients of Group II and (excellent + good) in 80% of Group I. There was no significant change in pulse rate and mean arterial pressure from the baseline value after the administration of muscle relaxants in either of the two groups.

CONCLUSIONS

Rocuronium bromide 0.9 mg/kg is a safer alternative to rocuronium bromide 0.6 mg/kg for endotracheal intubation with shorter time of onset and better intubating conditions.

摘要

背景

临床对起效迅速且作用时间短暂的非去极化肌松药的需求促使了罗库溴铵的研发。

目的

本研究旨在评估罗库溴铵用于气管插管的最佳剂量,并比较两种剂量罗库溴铵的起效时间、作用持续时间、插管条件及血流动力学效应。

设置与设计

一项前瞻性、随机、双盲研究。

材料与方法

所有患者以随机、双盲方式分为两组,每组20例。第一组患者静脉注射罗库溴铵0.6mg/kg,并于60秒后进行气管插管;第二组患者静脉注射罗库溴铵0.9mg/kg,并于60秒后进行气管插管。每隔10秒对手部拇收肌进行0.1Hz的单刺激以评估神经肌肉阻滞情况。

所用统计分析方法

对定性数据采用卡方检验,对定量数据采用学生t检验进行结果汇总及统计分析。

结果

与第一组相比,第二组的起效时间显著缩短(P<0.01),作用持续时间延长(P<0.001)。第二组100%的患者插管条件为(优+良),第一组为80%。两组在给予肌松药后,脉搏率和平均动脉压与基线值相比均无显著变化。

结论

对于气管插管,0.9mg/kg的罗库溴铵是0.6mg/kg罗库溴铵更安全的替代药物,其起效时间更短,插管条件更好。

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