背景:由于气道解剖结构的不同,儿科年龄组中意外困难气道的发生率高于成人,气道检查困难,先天性畸形.罗库溴铵的起效时间与琥珀酰胆碱的剂量相当。因此,我们比较了罗库溴铵与琥珀酰胆碱,以评估插管条件及其副作用,如果有的话。
方法:共有200名美国麻醉医师协会(ASA)I级和II级儿童患者进行择期手术。随机化后,R组(n=100)接受1.2mg/kg罗库溴铵,S组(n=100)静脉注射2mg/kg琥珀酰胆碱。确认面罩通气后,给研究药物,插管条件被评估为优秀,不错,可怜的,或不可能。将插管后的血流动力学变化记录为我们的次要结果。
结果:插管条件极好(65%),R组患者良好(25%)和一般(10%),而S组的结果是优秀的(60%),良好(20%),公平(15%),差(5%)(p=0.010)。S组插管后心率明显增高,而两组的收缩压或舒张压均无显著升高。
结论:在1.2mg/kg体重的剂量下,罗库溴铵是琥珀酰胆碱的更好替代品,可提供快速插管条件和稳定的血流动力学,且无相关不良反应.
BACKGROUND: The incidence of unanticipated difficult airways is higher in pediatric age groups than in adults due to the different airway anatomy, difficulty in airway examination, and congenital malformations. Rocuronium bromide has a comparable onset time to succinylcholine at its proportionate dose. Hence, we compared rocuronium bromide with succinylcholine to assess intubating conditions and their side effects, if any.
METHODS: A total of 200 pediatric patients of American Society of Anesthesiologists (ASA) grades I and II between one and 14 years of age of either sex posted for elective surgery were included in the study. After randomization, group R (n = 100) received 1.2 mg/kg rocuronium, and group S (n = 100) received 2 mg/kg succinylcholine intravenously. After confirming the mask ventilation, the study drugs were administered, and intubating conditions were assessed as excellent, good, poor, or impossible. Hemodynamic changes post-intubation were recorded as our secondary outcome.
RESULTS: Intubating conditions were excellent( 65%), good( 25%) and fair (10%) in patients of group R, while results in group S were excellent( 60%), good( 20%), fair (15%), and poor (5%) (p = 0.010). The heart rate was significantly increased post-intubation in group S, while there was no significant increase in systolic or diastolic blood pressure in either group.
CONCLUSIONS: At a dose of 1.2 mg/kg body weight, rocuronium was a better alternative to succinylcholine for providing rapid intubating conditions and stable hemodynamics without associated adverse effects.