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目的:比较不同剂量顺式阿曲库铵在短小的小儿腹腔镜手术的应用,选出合适肌松剂量以减少围手术时间,加快手术周转。方法:选择2013年1月-2014年1月深圳市儿童医院收治的80例腹股沟斜疝或鞘膜积液手术患儿,随机分为4组。A组以顺式阿曲库铵2倍ED95(0.1 mg/kg)为肌松剂;B组以顺式阿曲库铵2倍ED95(0.1 mg/kg)为肌松剂,术毕自主呼吸恢复即给予拮抗剂。C组以顺式阿曲库铵1.5倍ED95(0.075 mg/kg)为肌松剂;D组不使用肌松剂,以咪唑安定0.1 mg/kg辅助气管插管。结果:顺式阿曲库铵1.5倍ED95(0.075 mg/kg)组在自主呼吸恢复、清醒、拔管均优于其余3组,组间比较,差异具有统计学意义(P<0.05)。结论:1.5倍ED95顺式阿曲库铵诱导平稳,苏醒及自主呼吸恢复迅速,能够早期拔管,适于短小手术对快速周转的要求。
OBJECTIVE: To compare the application of different doses of cisatracurium in short pediatric laparoscopic surgery, select the appropriate dosage of muscle relaxants to reduce the perioperative time and speed up the operation. Methods: From January 2013 to January 2014, 80 children with inguinal hernia or hydrocele admitted to Shenzhen Children’s Hospital were randomly divided into 4 groups. In group A, ED95 (0.1 mg / kg) twice as much as cisatracurium was used as muscle relaxant; in group B, ED95 (0.1 mg / kg) twice as much as cisatracurium was used as muscle relaxant, Recovery is given as an antagonist. C group was treated with 1.5 times of cisatracurium ED95 (0.075 mg / kg) as muscle relaxant; Group D was given no muscle relaxants and assisted with midazolam 0.1 mg / kg. Results: The 1.5 times of cisatracurium ED95 (0.075 mg / kg) group had better spontaneous respiration, awake and extubation than the other three groups. The difference was statistically significant (P <0.05). Conclusion: 1.5 times ED95 cisatracurium induced stable, rapid recovery and spontaneous respiration, early extubation, suitable for short operation requirements for fast turnover.