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苏伽达ex 用于心脏手术患儿快速通道手术:一项随机对照研究。

Sugammadex for Fast-Track Surgery in Children Undergoing Cardiac Surgery: A Randomized Controlled Study.

机构信息

Department of Anesthesiology, Wenzhou Central Hospital, Wenzhou, China.

Department of Anesthesiology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China.

出版信息

J Cardiothorac Vasc Anesth. 2021 May;35(5):1388-1392. doi: 10.1053/j.jvca.2020.08.069. Epub 2020 Sep 3.

DOI:10.1053/j.jvca.2020.08.069
PMID:32962936
Abstract

OBJECTIVE

The purpose of this study was to evaluate the safety and efficacy of sugammadex for fast-track surgery in children undergoing cardiac surgery.

DESIGN

This was a prospective, randomized, controlled clinical study.

SETTING

University hospital.

PARTICIPANTS

The study comprised 60 children undergoing cardiac surgery.

INTERVENTIONS

The children in group S received sugammadex, 4 mg/kg, for reversal of neuromuscular block, and the children in group N received neostigmine, 30 µg/kg, and atropine, 15 µg/kg.

MEASUREMENTS AND MAIN RESULTS

The recovery time to a train-of-four of 0.9 and extubation time were significantly shorter in the group S than in group N (3.4 ± 1.2 min v 76.2 ± 20.5 min and 31.0 ± 6.4 min v 125.2 ± 21.6 min, respectively; p < 0.01). The heart rate after drug administration was higher in group S than in group N (102.7 ± 9.4 beats/min v 96.9 ± 8.5 beats/min; p = 0.03), whereas the mean arterial pressure after drug administration was similar in both groups. The length of hospital stay was shorter in group S (5.8 ± 1.0 v 6.5 ± 0.9 days; p = 0.03), and the hospitalization expenses were decreased in group S compared with that of group N ($1,036 ± $114 v $1,286 ± $187; p < 0.01). The incidence of postoperative atelectasis was less in group S than in group N (0 v 20%; p = 0.024).

CONCLUSION

Sugammadex can shorten the extubation time and reduce the incidence of postoperative atelectasis, with fewer adverse events, in children undergoing cardiac surgery. It may be beneficial to use sugammadex for fast-track surgery in children undergoing cardiac surgery.

摘要

目的

本研究旨在评估琥乙红霉素在儿童心脏手术快速康复中的安全性和有效性。

设计

这是一项前瞻性、随机、对照临床试验。

地点

大学医院。

参与者

本研究纳入 60 例行心脏手术的儿童。

干预措施

S 组患儿给予琥乙红霉素 4mg/kg 逆转神经肌肉阻滞,N 组患儿给予新斯的明 30μg/kg 和阿托品 15μg/kg。

测量和主要结果

S 组患儿的肌松恢复至 0.9 个成串刺激(TOF)的时间和拔管时间明显短于 N 组(3.4±1.2min 比 76.2±20.5min 和 31.0±6.4min 比 125.2±21.6min;p<0.01)。S 组患儿用药后心率高于 N 组(102.7±9.4 次/min 比 96.9±8.5 次/min;p=0.03),而两组患儿用药后的平均动脉压相似。S 组患儿的住院时间短于 N 组(5.8±1.0d 比 6.5±0.9d;p=0.03),且 S 组患儿的住院费用低于 N 组(1036±114 美元比 1286±187 美元;p<0.01)。S 组患儿术后肺不张的发生率低于 N 组(0%比 20%;p=0.024)。

结论

琥乙红霉素可缩短儿童心脏手术后的拔管时间,降低术后肺不张的发生率,且不良事件更少。对于行心脏手术的儿童,快速康复方案中使用琥乙红霉素可能有益。

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