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目的观察和比较米库氯铵和顺苯磺酸阿曲库铵用于婴幼儿唇腭裂手术中的肌松效应和安全性。方法 2012年9月至2013年9月择期行唇腭裂手术治疗的患儿60例,年龄6个月至3岁,随机分为两组,每组30例。两组均给予咪达唑仑0.1mg/kg、丙泊酚2mg/kg、瑞芬太尼1μg/kg及米库氯铵0.2mg/kg(M组)或顺苯磺酸阿曲库铵0.15mg/kg(C组)行麻醉诱导后气管插管。采用TOF-Guard加速度肌松监测仪连续监测尺神经四个成串刺激(TOF)。观察并记录肌松起效时间、临床作用时间和恢复指数,进行插管评级并观察不良反应情况。结果两组的插管条件评级差异无统计学意义。M组肌松起效时间、肌松临床作用时间以及恢复指数明显短于C组(P<0.05);M组不良反应发生率明显低于C组(P<0.05)。结论米库氯铵用于婴幼儿唇腭裂手术时起效快、肌松效应时间短,恢复较快。
Objective To observe and compare the muscle relaxant effect and safety of beccuronium and cisatracurium sulfonate for cleft lip and palate in infants. Methods From September 2012 to September 2013, 60 children undergoing cleft lip and palate surgery, ranging in age from 6 months to 3 years, were randomly divided into two groups (n = 30 in each group). Both groups were given midazolam 0.1 mg / kg, propofol 2 mg / kg, remifentanil 1 μg / kg, and mocockacloprid 0.2 mg / kg (group M) or atracurium citrate 0.15 mg / kg (group C) after intubation. Four series of ulnar nerve stimulations (TOFs) were continuously monitored using the TOF-Guard Accelerated Muscle Monitor. Observation and record of muscle relaxant onset time, clinical duration and recovery index, intubation rating and observation of adverse reactions. Results There was no significant difference in the ratings of intubation conditions between the two groups. The onset time of muscle relaxant, clinical duration and recovery index of muscle relaxant in group M were significantly shorter than those in group C (P <0.05). The incidence of adverse reactions in group M was significantly lower than that in group C (P <0.05). Conclusion The use of Miklobacl chloride in infants with cleft lip and palate surgery onset fast onset, muscle relaxation effect is short, faster recovery.