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[维库溴铵在腹腔镜检查术中的临床应用]

[Clinical use of vecuronium during celioscopy].

作者信息

Bertrand M, Lienhart A, Daloz M, Gendrel H, Dupuis M, Viars P

出版信息

Ann Fr Anesth Reanim. 1983;2(1):27-31. doi: 10.1016/s0750-7658(83)80046-x.

Abstract

In order to determine if vecuronium can be used for short operations, 40 women were studied during laparoscopy, randomly assigned to four groups: suxamethonium 1 mg X kg-1 in a single bolus followed by an infusion (group A), vecuronium 0.05 mg X kg-1 (group B), vecuronium 0.06 mg X kg-1 (group C) and vecuronium 0.07 mg X kg-1 (group D). Mean duration of operation was 22-25 min. Tracheal intubation can be performed in good conditions in all patients in group A and D, in 5/10 in group B and in 7/10 in group C. During laparoscopy, muscular relaxation was considered excellent in all patients in group A and D, 5/10 sufficient and 5/10 excellent in group C, 5/10 insufficient and 5/10 sufficient in group B. There were 7 reinjections in group B, 2 in group C and 1 in group A. The delay between the end of the procedure and extubation was the same in group A and C (7 min). This delay was significantly higher in group D (9 min). The delay between extubation and positive head lift test was significantly higher in group D. We conclude that the time course of action of vecuronium 0.06 mg X kg-1 is that required for a pelvic laparoscopy of 22-25 min; however, the conditions of intubation are not always perfect. Intubation is easier with a 0.07 mg X kg-1 dose; this dose induces a slight delay for extubation and positive head lift test. In all cases, the patient must be closely watched in a recovery ward.

摘要

为了确定维库溴铵是否可用于短时间手术,对40名接受腹腔镜检查的女性进行了研究,她们被随机分为四组:A组单次推注琥珀胆碱1mg/kg,随后进行输注;B组维库溴铵0.05mg/kg;C组维库溴铵0.06mg/kg;D组维库溴铵0.07mg/kg。平均手术时间为22 - 25分钟。A组和D组的所有患者、B组的5/10患者以及C组的7/10患者均可在良好条件下进行气管插管。在腹腔镜检查期间,A组和D组的所有患者肌肉松弛被认为极佳,C组5/10患者足够、5/10患者极佳,B组5/10患者不足、5/10患者足够。B组有7次追加注射,C组有2次,A组有1次。A组和C组手术结束至拔管的延迟相同(7分钟)。D组的这一延迟明显更长(9分钟)。D组拔管至抬头试验阳性的延迟明显更长。我们得出结论,0.06mg/kg维库溴铵的作用时间进程适用于22 - 25分钟的盆腔腹腔镜检查;然而,插管条件并非总是完美。0.07mg/kg剂量插管更容易;该剂量会导致拔管和抬头试验阳性稍有延迟。在所有情况下,患者在恢复病房都必须密切观察。

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