Abstract：Objective: To study the optimal minimum dose of cis-atracurium in laryngoscopic surgery for polyps of vocal cord. Methods: 120 patients who underwent laryngoscopic surgery for polyps of vocal cord from January 2017 to September 2018 were divided into two groups: group I (cis-atracurium 0.05 mg/kg during operation) and group II (cis-atracurium 0.075 mg/kg during operation), 60 cases in each group. The changes of heart rate (HR), mean arterial pressure (MAP), systolic blood pressure (SBP) and diastolic blood pressure (DBP) at different time points in different patients were compared. The degree of muscle relaxation at different time points was monitored and compared. The time from anesthesia to tracheal intubation, operation, drug withdrawal to spontaneous breathing recovery, extubation and eye opening were also compared between the two groups. Results: There was no significant difference in MAP, DBP and HR between the two groups at different time points (P> 0.05). SBP and DBP decreased significantly 1 min before intubation (T2) compared with after stable entry (T1) (P< 0.05). The onset time of T1 in group I was significantly longer than that in group II. The lowest value in T1 operation, T1 value in tracheal intubation, T1 value in laryngoscope insertion, T1 value in laryngoscope removal and TOF value in series were significantly higher than those in group II (P< 0.01). The time from induction of anesthesia to tracheal intubation, from drug withdrawal to recovery of spontaneous breathing, extubation and eye opening in group I were significantly shorter than those in group II (P< 0.01), but there was no significant difference in the operation time between the two groups (P> 0.05). Conclusion: The application of cis-atracurium in resection of polyp of vocal cord under self-retaining laryngoscope is in line with remifentanil and propofol target-controlled intravenous anesthesia. The intraoperative circulation is stable. Although the low dose of cis-atracurium (0.05 mg/kg) can not completely prevent muscle tremor, it can meet the needs of muscle relaxation in tracheal intubation and self-retaining laryngoscope operation and reduce the anesthesia time of operation.
曹清香, 任潇勤, 王增娟. 声带息肉支撑喉镜手术中顺式阿曲库铵适合的最小剂量研究[J]. 河北医学, 2019, 25(9): 1508-1502.
CAO Qingxiang, REN Xiaoqin, WANG Zengjuan. Study on the Minimum Dose of Cis-atracurium in Laryngoscopic Surgery for Polyps of Vocal Cord. HeBei Med, 2019, 25(9): 1508-1502.
[1] Hraiech S, Forel JM, Guervilly C, et al.DOI: 10.1186/s13613-017-0305-2. How to reduce cisatracurium consumption in ARDS patients: the TOF-ARDS study[J].Ann Intensive Care,2017,7(1):79. [2] Bouju P, Tadié JM, Barbarot N, et al. Clinical assessment and train-of-four measurements in critically ill patients treated with recommended doses of cisatracurium or atracurium for neuromuscular blockade: a prospective descriptive study[J].Ann Intensive Care,2017,7(1):10. [3] 李新龙,杨昌国.支撑喉镜与纤维喉镜辅助切除声带息肉术临床疗效及预后比较[J].河北医学,2018,24(7):1128~1131. [4] Zeng R, Liu X, Zhang J,et al.The efficacy and safety of mivacurium in pediatric patients[J].BMC Anesthesiol,2017,17(1):58. [5] 路璐,梁思,陈磊,等.顺阿曲库铵用于阻塞性黄疸患者肌松效应及安全性[J].医学研究与教育,2016,33(6):12~16. [6] Park WY, Choi JC, Yun HJ,et al.Optimal dose of combined rocuronium and cisatracurium during minor surgery: A randomized trial[J].Medicine (Baltimore),2018,97(10):e9779. [7] You AH, Kang HY, Park SW,et al.Delayed recovery of limb muscle power after general anesthesia with cisatracurium in a dermatomyositis patient[J].Clin Anesth,2018,50(1):59~60. [8] Kounis NG, Koniari I, Chourdakis E,et al.Negative association between previous allergy and intradermal tests for rocuronium and cisatracurium: what about additional tests[J].Korean Anesthesiol, 2018,71(4):328~329. [9] Kim YY, Kim IT, Shin SI, et al.Intradermal skin tests for rocuronium and cisatracurium in patients with a history of allergy: a retrospective study[J].Korean Anesthesiol,2017,1(4):296~299.
2019, Vol. 25 
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