在腹腔镜手术患者中使用pipecuronium进行深度神经肌肉阻塞 - 一个潜在的案例系列
László Asztalos1, Zoltán Szabó-Maák1, Mariann Berhés1
1Department of Anesthesiology and Intensive Care, University of Debrecen, Faculty of Medicine, Debrecen, Hungary.
Anaesthesia, critical care & pain medicine
|February 21, 2025
概括
皮佩库在腹腔镜手术期间有效诱导和维持深度神经肌肉阻塞,允许低腹内压力. 苏加马德克斯安全而快速地逆转了阻塞,证明了管道.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
- 手术创新 在外科创新.
背景情况:
- 评估在经过腹腔镜手术的患者中,在pipecuronium诱导的深度神经肌肉阻塞期间维持低腹内压力 (<10 mmHg) 的可行性 (后瘤计数≥1,四列计数 = 0).
- 研究pipecuronium化物在非选择性腹部手术中的肌肉松的安全性和有效性.
研究的目的:
- 为了评估在腹腔镜手术期间使用pipecuronium维持深度神经肌肉阻塞.
- 为了评估使用pipecuronium诱导阻塞的低腹内压力的可行性.
- 为了确定sugammadex用于逆转pipecuronium诱导的神经肌肉阻塞的疗效和安全性.
主要方法:
- 包括10名接受非选择性腹部手术的成年患者.
- 皮佩库胺 (0.09 mg/kg) 用于肌肉放松和深层阻塞维护,并根据需要补充剂量 (0.01-0.02 mg/kg).
- 腹腔内压力保持在10mmHg以下,并使用前瘤后计数和四次列车计数监测神经肌肉阻塞.
主要成果:
- 皮皮库的诱导剂量 (0.09 mg/kg) 达到深度阻塞,平均持续时间为51.2±19.7分钟.
- 苏加马德克斯 (2毫克/公斤) 迅速扭转了神经肌肉阻塞,在3.5±1.6分钟内实现了四列列车比率≥0.9.
- 平均腹腔内压是8.1±1.1mmHg,没有观察到心率的显著变化.
结论:
- 皮佩库是一种适合在需要时实现深度神经肌肉阻塞的药物.
- 它的长效性质可以由sugammadex有效和安全地对抗.
- 这种方法支持在腹腔镜手术期间维持低腹内压力.
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