顺阿曲库铵不同给药方式在达芬奇辅助腹腔镜肾上腺切除术中应用效果

The application effect of different rocuronium administration methods in Da Vinci-assisted laparoscopic adrenalectomy

摘要:

目的 探讨顺阿曲库铵不同给药方式在达芬奇辅助腹腔镜肾上腺切除术中的应用效果。方法 采用前瞻性随机对照试验设计，选取2022年1月—2024年1月在西湖大学医学院附属杭州市第一人民医院接受达芬奇机器人辅助腹腔镜肾上腺切除术的120例患者为研究对象。将患者随机分为靶控输注组与持续输注组，每组60例。比较两组肌松起效时间、维持时间、麻醉维持用药量、麻醉时间、术中出血量、手术时间、术后引流管留置时间、术后卧床时间及麻醉相关并发症发生率的差异。结果 靶控输注组的肌松起效时间和麻醉时间短于持续输注组（P <0.05），肌松维持时间长于持续输注组（P <0.05），麻醉维持用药剂量小于持续输注组（P <0.05），靶控输注组术中出血量少于持续输注组（P <0.05）。此外，靶控输注组的手术时间、术后引流管留置时间及术后卧床时间均短于持续输注组（P <0.05），靶控输注组麻醉相关并发症发生率和术后发生Clavien≥3级并发症的比例均低于持续输注组（P <0.05）。结论 靶控输注顺阿曲库铵在达芬奇辅助腹腔镜肾上腺切除术中的应用效果相比持续输注方式，在缩短手术时间、减少术中出血量、降低麻醉用药量及提高术后恢复速度方面具有显著优势，并能有效降低麻醉相关并发症的风险。

Abstract:

Objective To investigate the effects of different rocuronium administration methods in Da Vinci-assisted laparoscopic adrenalectomy.Methods This study used a prospective randomized controlled trial design, selecting 120 patients who underwent Da Vinci robot-assisted laparoscopic adrenalectomy in our hospital from January 2022 to January 2024. The patients were randomly divided into a target-controlled infusion group and a continuous infusion group, with 60 cases in each group. The differences between the two groups were observed in terms of muscle relaxation onset time, maintenance time, anesthetic maintenance dosage, anesthesia duration, intraoperative blood loss, operation time, postoperative drainage tube retention time, postoperative bed rest time, and the incidence of anesthesia-related complications.Results The muscle relaxation onset time and anesthesia duration in the target-controlled infusion group was shorter than in the continuous infusion group (P < 0.05), the muscle relaxation maintenance time was longer than in the continuous infusion group (P < 0.05), and the anesthetic maintenance dosage was lower than in the continuous infusion group (P < 0.05). The intraoperative blood loss in the target-controlled infusion group was less than in the continuous infusion group (P < 0.05). Additionally, the operation time, postoperative drainage tube retention time, and postoperative bed rest time in the target-controlled infusion group were shorter than in the continuous infusion group (P < 0.05). The incidence of anesthesia-related complications and the proportion of postoperative Clavien ≥3 grade complications were lower in the target-controlled infusion group compared to the continuous infusion group (P < 0.05).Conclusion Target-controlled infusion of rocuronium in Da Vinci-assisted laparoscopic adrenalectomy has significant advantages over continuous infusion in terms of shortening operation time, reducing intraoperative blood loss, lowering anesthetic dosage, and improving postoperative recovery speed. It can also effectively reduce the risk of anesthesia-related complications.