摘要
目的 评估脊柱手术中运动诱发电位监测期间,使用舒更葡糖钠拮抗神经肌肉阻滞对患者术中体动、呛咳、气道峰压等安全性影响。方法 本研究为两项随机对照试验的回顾性分析,纳入分析的择期行胸、腰段脊柱手术的患者均进行术中运动诱发电位监测。术中持续泵注罗库溴铵并维持中度阻滞,在开始运动诱发电位监测时停止罗库溴铵泵注,给予2 mg/kg的舒更葡糖钠。比较患者舒更葡糖钠给药前、给药后5、10、20、30和60 min的术中体动、呛咳、气道峰压、舒更葡糖钠过敏情况、动脉压、心率、呼气末二氧化碳压以及4个成串刺激比率(TOFr)。结果 最终纳入分析的患者共计120例。舒更葡糖钠给药前,TOFr为0.2,给予舒更葡糖钠5、10、20、30和60 min时,TOFr分别为0.8、0.8、0.9、0.9和0.9。全部患者均未发生术中体动情况,无术中呛咳发生,无舒更葡糖钠过敏。与舒更葡糖钠给药前相比,给药后5、10、20、30和60 min心率均明显降低(P<0.05),其余指标无显著改变。结论 脊柱手术中运动诱发电位监测期间,使用舒更葡糖钠拮抗神经肌肉阻滞是安全的。
Objective To explore the effect of sugammadex on safety indicators such as body movement,choking,peak airway pressure during spinal surgery with motor evoked potential monitoring.Methods This study was a retrospective analysis of two randomized controlled trials.Patients undergoing selective thoracic and lumbar spinal surgery with intraoperative motor evoked potential monitoring were included.Rocuronium was continuously infused and the train-of-four stimulation count was maintained at 2.When motor evoked potential monitoring started,stop rocuronium infusion and 2 mg/kg of sugammadex was given.Indicators were compared between administration of sugammadex and 5,10,20,30,60 minutes after administration like body movement,choking,peak airway pressure,allergic reaction,mean arterial pressure,heart rate,end expiratory pressure of CO 2 and the train-of-four stimulation ratio(TOFr).Results A total of 120 patients were finally included in the analysis.Before administering sugammadex,TOFr was 0.2.At 5,10,20,30 and 60 minutes after administration,TOFr were 0.8,0.8,0.9,0.9,0.9 respectively.No patient experienced intraoperative body movement,choking,or allergy reaction.Compared with the time of sugammadex administration,heart rate was significantly reduced 5,10,20,30 and 60 minutes after administration(P<0.05),there was no significant change in the remaining indicators.Conclusions Sugammadex can be safely used during spinal surgery with motor evoked potential monitoring.
作者
马博
菅敏钰
景龙年
王成尉
刘海洋
韩如泉
MA Bo;JIAN Minyu;JING Longnian;WANG Chengwei;LIU Haiyang;HAN Ruquan(Department of Anesthesiology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)
出处
《基础医学与临床》
2025年第6期807-810,共4页
Basic and Clinical Medicine
基金
吴阶平医学基金会临床科研专项基金(320.6750.18176,320.6750.2021-05-1)。
