Abstract:

Objective　To observe the effects of total intravenous anesthesia with cisatracurium in different ways for renal transplantation on the anesthetic amount and the patients' recovery indicators. Methods　One hundred and twenty-three patients who took renal transplantation at Zhengzhou Seventh People's Hospital from January 2021 to October 2022 were selected for the randomized controlled trial. They were divided into groups A (62 cases) and B (61 cases) by lottery. There were 30 males and 32 females in group A; they were (62.58±5.33) years old. There were 31 males and 30 females in group B; they were (60.46±5.29) years old. Group A took target-controlled infusion, and group B continuous infusion. The anesthesia, operation, postoperative recovery, and anesthesia safety of the two groups were compared. t and χ² tests were applied. Results　After the anesthesia by different administration methods, the onset time of muscle relaxation in group A was shorter than that in group B, and the maintenance time was longer than that in group B (both P<0.05); the maintenance dose of anesthesia in group A was lower than that in group B [(27.22±5.13) mg vs. (30.77±5.48) mg, t=3.710, P<0.001)]. There were no statistical differences in the intraoperative bleeding volume and operation time between the two groups (both P>0.05). The postoperative eye opening time and extubation time in group A were shorter than those in group B [(7.45±2.28) min vs. (8.82±2.36) min and (9.27±2.46) min vs. (10.49±2.39) min; t=3.274 and 2.789; P=0.001 and 0.006)]. The times for the recovery of muscle relaxation (TOF) ≥ 25% and ≥ 75% in group A were shorter than those in group B (both P<0.05). The incidence of anesthesia related complications in group A was lower than that in group B [4.84% (3/62) vs. 14.75% (9/61); χ²=5.558, P=0.018]. Conclusion　Target controlled infusion of cisatracurium has high application value in total intravenous anesthesia for renal transplantation, can shorten the onset time of anesthesia and enhance the muscle relaxation effect, and has positive significance in reducing the amount of drug in maintaining anesthesia, improving the recovery of muscle relaxation, and reducing the risk of anesthesia related complications.

Key words:

Renal transplantation, Ciatracurium, Target controlled infusion, Continuous infusion

摘要：

目的　观察在肾移植术的全凭静脉麻醉中通过不同方式给予顺阿曲库铵对麻醉用药量及患者恢复指标的影响。方法　选取郑州市第七人民医院2021年1月至2022年10月于郑州市第七人民医院接受肾移植术治疗的123例患者进行随机对照试验，采用抽签法将其分为A组（62例）和B组（61例）。A组男30例，女32例，年龄（62.58±5.33）岁。B组男31例，女30例，年龄（60.46±5.29）岁。A组靶控输注给药，B组持续输注给药。比较两组麻醉情况、手术情况、术后恢复情况及麻醉安全性。采用t检验和χ²检验。结果　经不同给药方式麻醉后，A组肌松起效时间短于B组，维持时间长于B组（均P<0.05），麻醉维持用药量低于B组［（27.22±5.13）mg比（30.77±5.48）mg；t=3.710，P<0.001］。两组术中出血量及手术时间差异均无统计学意义（均P>0.05）。A组术后睁眼时间、拔管时间均短于B组［（7.45±2.28）min比（8.82±2.36）min、（9.27±2.46）min比（10.49±2.39）min；（t=3.274、2.789，P=0.001、0.006）］。A组肌松恢复程度（TOF）≥25%、≥75%用时均短于B组（均P<0.05）。术后，A组麻醉相关并发症发生率低于B组［4.84%（3/62）比14.75%（9/61）；χ²=5.558，P=0.018］。结论　靶控输注顺阿曲库铵在肾移植术的全凭静脉麻醉中具有较高应用价值，可缩短患者麻醉起效时间，增强肌松效果，对减少麻醉维持用药量、改善肌松恢复情况、降低麻醉相关并发症发生风险均有积极意义。

关键词:

肾移植术, 顺阿曲库铵, 靶控输注, 持续输注