患者在清醒或镇静状态下校准定标对术后肌松监测指标的影响

doi:10.3969/j.issn.1006-7795.2013.05.003

首都医科大学学报 ›› 2013, Vol. 34 ›› Issue (5): 651-654.doi: 10.3969/j.issn.1006-7795.2013.05.003

患者在清醒或镇静状态下校准定标对术后肌松监测指标的影响

尹橙, 薛纪秀, 叶新, 马艳辉, 阎彦宏

首都医科大学宣武医院麻醉科, 北京 100053

收稿日期:2013-06-12 出版日期:2013-10-21 发布日期:2013-10-22
通讯作者: 薛纪秀 E-mail:xuejixiu1@163.com
基金资助:
首都医科大学附属北京妇产医院院内课题资助项目(201108);贝朗麻醉科学研究基金资助项目(BBF007)。

Effects of calibration in patients in awakened or sedated status on postoperative muscle relaxant monitoring value

YIN Cheng, XUE Jixiu, YE Xin, MA Yanhui, YAN Yanhong

Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China

Received:2013-06-12 Online:2013-10-21 Published:2013-10-22
Contact: 薛纪秀 E-mail:xuejixiu1@163.com
Supported by:
This study was supported by Hospital Project of Beijing Obsterical and Gynecological Hospital, Capital Medical University(201108), the Project of B. Braun Medical Anesthesiology Research Fund (BBF007).

摘要/Abstract

摘要：

目的观察患者在清醒或镇静状态下行单刺激肌颤搐(single twitch stimulation,T₁)与4个成串刺激(train of four,TOF)(T₄/T₁)校准定标,对术后T₁与TOF值是否有影响。方法将40例ASAⅠ或Ⅲ级患者采用数字表法随机均分为2组(每组20例):清醒组(A组)与镇静组(S组)。清醒组在患者未给予任何镇静剂情况下对T₁与TOF校准定标,镇静组在患者给予依托咪酯使BIS处于40~60时校准定标。2组患者术中均不使用肌松药。观察2组患者术后清醒脑电双频指数(bispectral index,BIS)值恢复至术前水平时T₁与TOF最大值。结果镇静组患者术后T₁最大值明显高于清醒组患者(P=0.005),两组患者术后TOF最大值比较,差异无统计学意义(P=0.191)。结论在肌松监测观察中,患者清醒状态下进行T₁与TOF校准定标,对术后T₁值影响小,更具有临床指导意义。

关键词: 肌松监测, 闭环肌松注射系统, 校准定标, 4个成串刺激

Abstract:

Objective To observe the effects of calibration in patients in awakened or sedated status for single twitch stimulation (T₁) and train-of-four (TOF) (T₄/T₁) on postoperative T₁ and TOF value. Methods Forty patients at ASAⅠor Ⅲ level, were divided into two groups at random: The awakened group (group A) and the sedation group (group S). In the group A, calibrated T₁ and TOF in the case of patients without given any sedative, and in the sedation group, calibrated when patients were given etomidate to make BIS in 40-60. Two groups of patients were not given muscle relaxants. The maximum values of T₁ and TOF were observed while the BIS value of two groups of patients with postoperative awake returned to preoperative levels. Results The postoperative T₁ maximum value of patients in the group S was obviously higher than it in the group A(P=0.005), there was no statistically significant difference between two groups of postoperative TOF in maximum value comparison(P=0.191).Conclusion In the observation of muscle relaxant monitoring, patients in awakened status underwent the T1 and TOF calibration, which caused a small effect on postoperative T₁ value, has more clinical significance.

Key words: neuromuscular monitoring, close-loop muscle relaxant injection system, calibration, train-of-four (TOF)

中图分类号:

R246.2

尹橙, 薛纪秀, 叶新, 马艳辉, 阎彦宏. 患者在清醒或镇静状态下校准定标对术后肌松监测指标的影响[J]. 首都医科大学学报, 2013, 34(5): 651-654.

YIN Cheng, XUE Jixiu, YE Xin, MA Yanhui, YAN Yanhong . Effects of calibration in patients in awakened or sedated status on postoperative muscle relaxant monitoring value[J]. Journal of Capital Medical University, 2013, 34(5): 651-654.

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患者在清醒或镇静状态下校准定标对术后肌松监测指标的影响

Effects of calibration in patients in awakened or sedated status on postoperative muscle relaxant monitoring value

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