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论著:经气管镜超声引导针吸活检术持续输注琥珀胆碱的可行性与安全性
Feasibility of Continuous Succinylcholine Infusion for General Anesthesia in Endobronchial Ultrasound Guided Transbronchial Needle Aspiration
殷曰昊 顾悦超 王昕 谭志明
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作者单位:复旦大学附属肿瘤医院麻醉科
中文关键字:经气管镜超声引导针吸活检术;琥珀胆碱;全身麻醉
英文关键字:Endobronchial ultrasound guided transbronchial needle aspiration; Succinylcholine; General anesthesia
中文摘要:目的:探讨经气管镜超声引导针吸活检术(endobronchial ultrasound guided transbronchial needle aspiration,EBUS TBNA)持续输注琥珀胆碱的可行性和安全性。方法:择期行EBUS TBNA的患者73例,静脉注射咪达唑仑0.04 mg/kg、芬太尼2 μg/kg;异丙酚靶控输注,设定其血浆浓度为3 μg/mL;琥珀胆碱0.5 mg/kg静脉注射后,以3 mg/(kg·h)注射。全麻诱导 1 min后置入喉罩,连接麻醉机行机械通气。监测并记录患者的血压(BP)、心率(HR)和脉搏氧饱和度(SpO2);记录术中和术后患者有无呛咳及心血管系统不良反应等并发症;记录琥珀胆碱的用量、手术时间和手术结束至拔除喉罩的时间。手术结束时抽取静脉血,检测血清钾离子(K+)浓度。结果:所有患者术中均无呛咳及窦性心动过缓发生,术后能够快速恢复自主呼吸,拔除喉罩后无低氧血症发生;琥珀胆碱的用量为(2.08±1.73) mg/kg;术后血K+浓度与术前比较无显著差异(P>0.05)。
结论:全麻EBUS TBNA时持续输注琥珀胆碱是安全、有效的。
英文摘要:Objective: To evaluate the applicability and safety of continuous succinylcholine infusion for general anesthesia in endobronchial ultrasound guided transbronchial needle aspiration (EBUS TBNA). Methods:Seventy three patients were scheduled to undergo EBUS TBNA. Anesthesia was induced with midazolam 0.04 mg/kg, fentanyl 2 μg/kg, target controlled infusion (TCI) propofol 3 μg/mL, succinylcholine 0.5 mg/kg and maintained with 3 mg/kg/h. Laryngeal mask was used at 1 min after intravenous succinylcholine. The succinylcholine consumption, surgical time and the extubation time were recorded. Serum potassium concentration was measured after EBUS TBNA. Results: All patients have finished EBUS TBNA successfully without any serious complications. And the spontaneous respiration recovered rapidly after the end of EBUS TBNA. The succinylcholine consumption was (2.08±1.73)mg/kg. There was no significant difference in the serum potassium levels before and after the operation (P>0.05). Conclusions: EBUS TBNA can be safely performed under continuous succinylcholine infusion for general anesthesia.
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