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华西医学  2015 

丙泊酚和七氟烷对米库氯铵组胺释放的影响

DOI: 10.7507/1002-0179.20150252, PP. 877-880

Keywords: 米库氯铵,组胺,丙泊酚,七氟烷

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Abstract:

目的?比较全凭静脉与全凭吸入两种不同的麻醉方案对米库氯铵组胺释放的影响。方法?2012年3月-10月将40例美国麻醉医师协会分级Ⅰ~Ⅱ级择期行耳鼻喉手术的患者随机分为静脉丙泊酚靶浓度控制输注(TCI)组(丙泊酚组)和吸入七氟烷组(七氟烷组)。丙泊酚组用TCI进行丙泊酚靶控输入。七氟烷组采用七氟醚面罩通气诱导。分别在注射米库氯铵0.16mg/kg前(T0),注药后1min(T1)、3min(T2)、5min(T3),测定并记录相应时间点血清组胺浓度、平均动脉压和心率。观察并记录有无皮肤红斑、气道压增高等过敏反应症状。结果?两组心率、血压在诱导期间有一定下降,但差异无统计学意义(P>0.05)。T0~T3时各组心率与平均动脉压差异无统计学意义(P>0.05)。与T0比较,两组在T1~T2时间点组胺浓度显著升高(P<0.05),在T3时降低但仍高于T0。在T1~T3,丙泊酚组的组胺浓度高于七氟烷组(P<0.05)。两组患者均未观察到皮肤红斑、支气管痉挛等米库氯铵副作用发生。结论?0.16mg/kg米库氯铵静脉注射用于丙泊酚静脉麻醉或七氟烷吸入麻醉在较短时间内引起血清组胺浓度的轻度升高,但并未引起患者发生有临床症状的过敏反应,不影响患者血流动力学稳定,可在临床安全使用。

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