静脉输注顺阿曲库铵用于肝癌患者射频消融术的肌松效应(1)
【摘要】 目的：评价射频消融对静脉输注顺阿曲库铵肌松效应的影响，探讨顺阿曲库铵用于肝癌患者射频消融术的肌松效应。方法：选取于2014年8月-2016年12月本院就诊的肝癌患者40例，根据手术方式分为对照组(非消融术组，C组)和消融术组(R组)两组，每组各20例。两组患者均咪达唑仑0.02 mg/kg静脉注射后，全凭吸入麻醉诱导，气管插管并行机械通气，靶控输注丙泊酚和瑞芬太尼维持麻醉，R组射频针开始加温时(C组对应时间点)静脉注射顺阿曲库铵0.15 mg/kg，采用TOF-Watch SX加速度仪监测肌松程度，记录术中患者顺阿曲库铵起效时间、肌颤搐最大抑制程度、临床作用时间、恢复指数，记录患者不同时点体温及对应的血压、心率。结果：随着手术的进程，患者体温逐步上升，血压升高，心率增快。同C组相比，R组顺阿曲库铵肌颤搐最大抑制程度下降，临床作用时间缩短，恢复指数减小(P<0.05)，但起效时间比较差异无统计学意义(P>0.05)。结论：顺阿曲库铵用于肝癌患者射频消融术的肌松效应降低。
【关键词】 高温； 肌松效应； 射频消融术
, 百拇医药
Neuromuscular Block Effects of Cisatracurium in Liver Cancer Patients Undergoing Radiofrequency Ablation Operation/LIU Xiaoping，LI Liwei.//Medical Innovation of China，2018，15(01)：052-055
【Abstract】 Objective：To investigate the neuromuscular block effects of Cisatracurium in liver cancer patients undergoing radiofrequency ablation operation.Method：40 liver cancer patients undergoing radiofrequency ablation operation from August 2014 to December 2016 were selected as the objects.According the operation method They were divided into two groups，the control group(non-ablation group，group C) and ablation group(group R)，20 cases in each group.Two groups of patients were given Midazolam 0.02 mg/kg after intravenous injection， all inhaled anesthesia induction，tracheal intubation and mechanical ventilation，target controlled infusion of Propofol and Remifentanil for anesthesia.Using TOF-Watch SX acceleration to monitor the degree of muscle relaxation，Cisatracurium onset time， maximum twitch depression， the clinical duration and recovery index were recorded at different time points corresponding to the body temperature and blood pressure and heart rate.Result：With the process of operation， the patients’ body temperature rises gradually， the blood pressure rises， and the heart rate increases rapidly. Compared with the group C，group R of cisatracurium muscle twitch maximal inhibition decreased， the clinical effect to shorten the time，reduce the recovery index(P<0.05)，but there was no significant difference in the onset time (P>0.05).Conclusion：Cisatracurium used in the reduction of muscle relaxant effect in radiofrequency ablation of liver cancer patients.
, 百拇医药
【Key words】 Temperature； Neuromuscular block； Radiofrequency ablation operation
First-author’s address：SU Huazan Hospital of Zhongshan，Zhongshan 528400，China
doi：10.3969/j.issn.1674-4985.2018.01.014
隨着热疗技术的不断发展，术中患者体温变化的情况日益增多，其中肝癌射频消融术(radiofrequency ablation，RFA)临床应用尤为广泛[1]，尤其是多发或者较大的肿瘤时，往往需要全身麻醉。研究表明，体温的变化可影响生理功能及药物的药理学变化[2-3]。前期实验研究表明，体温升高时家兔顺阿曲库铵肌松效应降低[4]，但是临床研究未见报道。肝癌RFA时患者局部温度和全身温度都有不同程度的升高[5-6]，顺阿曲库铵用于肝癌RFA时的药理学特征可能产生较为复杂的变化，有必要探讨射频消融对静脉输注顺阿曲库铵肌松效应的影响。本研究拟评价顺阿曲库铵用于肝癌射频消融术患者的肌肉松弛效果，为临床这类患者肌松药的应用提供理论参考，现报道如下。, http://www.100md.com(刘小平 李立伟)
【关键词】 高温； 肌松效应； 射频消融术
, 百拇医药
Neuromuscular Block Effects of Cisatracurium in Liver Cancer Patients Undergoing Radiofrequency Ablation Operation/LIU Xiaoping，LI Liwei.//Medical Innovation of China，2018，15(01)：052-055
【Abstract】 Objective：To investigate the neuromuscular block effects of Cisatracurium in liver cancer patients undergoing radiofrequency ablation operation.Method：40 liver cancer patients undergoing radiofrequency ablation operation from August 2014 to December 2016 were selected as the objects.According the operation method They were divided into two groups，the control group(non-ablation group，group C) and ablation group(group R)，20 cases in each group.Two groups of patients were given Midazolam 0.02 mg/kg after intravenous injection， all inhaled anesthesia induction，tracheal intubation and mechanical ventilation，target controlled infusion of Propofol and Remifentanil for anesthesia.Using TOF-Watch SX acceleration to monitor the degree of muscle relaxation，Cisatracurium onset time， maximum twitch depression， the clinical duration and recovery index were recorded at different time points corresponding to the body temperature and blood pressure and heart rate.Result：With the process of operation， the patients’ body temperature rises gradually， the blood pressure rises， and the heart rate increases rapidly. Compared with the group C，group R of cisatracurium muscle twitch maximal inhibition decreased， the clinical effect to shorten the time，reduce the recovery index(P<0.05)，but there was no significant difference in the onset time (P>0.05).Conclusion：Cisatracurium used in the reduction of muscle relaxant effect in radiofrequency ablation of liver cancer patients.
, 百拇医药
【Key words】 Temperature； Neuromuscular block； Radiofrequency ablation operation
First-author’s address：SU Huazan Hospital of Zhongshan，Zhongshan 528400，China
doi：10.3969/j.issn.1674-4985.2018.01.014
隨着热疗技术的不断发展，术中患者体温变化的情况日益增多，其中肝癌射频消融术(radiofrequency ablation，RFA)临床应用尤为广泛[1]，尤其是多发或者较大的肿瘤时，往往需要全身麻醉。研究表明，体温的变化可影响生理功能及药物的药理学变化[2-3]。前期实验研究表明，体温升高时家兔顺阿曲库铵肌松效应降低[4]，但是临床研究未见报道。肝癌RFA时患者局部温度和全身温度都有不同程度的升高[5-6]，顺阿曲库铵用于肝癌RFA时的药理学特征可能产生较为复杂的变化，有必要探讨射频消融对静脉输注顺阿曲库铵肌松效应的影响。本研究拟评价顺阿曲库铵用于肝癌射频消融术患者的肌肉松弛效果，为临床这类患者肌松药的应用提供理论参考，现报道如下。, http://www.100md.com(刘小平 李立伟)