|
|
|
| Effect of Muscle Relaxation on Surgical Conditions of Uterine Leiomyoma in Elderly Women |
| WANGHui-de, ZHONGQing, WENGYan |
| Department of Anesthesiology, Jianyang People's Hospital, Jianyang, Sichuan Province, 641400 China |
|
|
|
|
Abstract 【Objective】 To investigate the effect of muscle relaxation on the surgical conditions of elderly women with uterine fibroids (leiomyoma). 【Methods】 A total of 86 patients who underwent laparoscopic myomectomy in our hospital from January 2010 to November 2017 were selected and divided into the control group and the observation group according to random number table, with 43 cases each. Both groups of patients underwent continuous infusion of cis-atracurium to maintain muscle relaxation. In the observation group, the target muscle relaxation degree was TOF1-2 (moderate muscle relaxation, i.e. four series of stimulation can maintain 1-2 muscle twitch). In the control group, the target degree of muscle relaxation was PTC1-2 (deep muscle relaxation, i.e. 1-2 monostimulatory twitch after tetanic stimulation). Operating conditions, endotracheal intubation conditions, recovery of muscle relaxants, surgeon score, and incidence of adverse reactions were compared between the two groups. 【Results】 There was no significant difference in operative time and surgeon score between the observation group and the control group (P>0.05). The mean pneumoperitoneal pressure and the extubation time in the observation group were higher than those in the control group. The ratios of 4 string stimulations (TOFr) recovery to 0.7 and 0.9 in the observation group were shorter than those in the control group (P<0.05) . The excellent and good rate of tracheal intubation was 100.00% in both groups. The total incidence of adverse reactions in the two groups was 6.96% and 4.64%, respectively, with no significant difference (P>0.05). 【Conclusion】 The treatment of TOF1-2 muscle relaxant in elderly women with uterine fibroids can obtain better operating conditions and tracheal intubation conditions. The recovery time of muscle relaxant is short. There were no obvious adverse reactions, which can be further popularized and used in clinical practice.
|
|
Received: 11 May 2018
|
|
|
|
|
|
[1] 朱璐,陈红天,丁正香,等.子宫肌瘤常见中医证候超声声像图特征及其相关性研究[J].世界中医药,2016,11(6):966-968.
[2] 冯九香,李婉萍.腹腔镜下子宫肌瘤剔除术对患者预后及血清疼痛指标的影响[J].医学临床研究,2018,35(1):108-110.
[3] 朱小兵,吴论,王根保,等.长期糖皮质激素用药对腹腔镜手术患者顺阿曲库铵肌松效应的影响[J].中华麻醉学杂志,2016,36(9):1122-1125.
[4] Kajiura A, Nagata O, Takizawa Y,et al.A large individual variation in both the infusion rate and the blood concentration of rocuronium necessary for obtain adequate surgical muscle relaxation during total intravenous anesthesia with propofol and remifentanil[J].J Anesth,2015,29(1):9-14.
[5] 陈苑.顺式阿曲库铵持续输注用于腹腔镜手术深度肌松和适度肌松的比较[D].浙江大学,2015.
[6] 汪涛,李荣.腹腔镜手术中顺式阿曲库铵不同输入方式维持肌松深度的比较[J].现代仪器与医疗,2017,23(5):71-72.
[7] 于洋,梁淑娟,何文胜,等.右美托咪定对小儿腹腔镜手术中顺式阿曲库铵肌松效应的影响[J].现代药物与临床,2017,32(5):875-879.
[8] 程勇,郭建荣,任芹,等.不同通气模式对高龄腹腔镜胆囊切除手术患者呼吸力学、血气分析及血流动力学的影响[J].中国老年学杂志,2017,37(10):2492-2494.
[9] 李机,张庆国,刘中杰,等.腹腔镜手术中持续输注与间断静注顺式阿曲库铵维持深度肌松的药效学比较[J].临床麻醉学杂志,2016,32(4):321-324. |
|
|
|
2018, Vol. 35 
