刘娜,王丰,周倩,高鸿,邹小华
LIU Na,WANG Feng,ZHOU Qian,GAO Hong,ZOU Xiaohua

• 1:贵州医科大学麻醉学院
• 2:贵州医科大学
• 3:贵州医科大学附院麻醉科

摘要(Abstract)：

目的:观察吸烟对成年男性患者全身麻醉术中罗库溴铵肌松作用时效及术后舌后坠及呼吸抑制等并发症的影响。方法:择期在全身麻醉下行泌尿外科手术的成年男性患者100例,年龄20～60岁,BMI 18～22 kg/m2,ASA分级Ⅰ～Ⅱ级,根据患者是否吸烟分为非吸烟组(C组)和吸烟组(S组);患者麻醉过程中采用TOF Watch仪行肌松监测、行4个成串刺激(TOF),记录并比较两组患者罗库溴铵起效时间、临床作用时间、恢复指数,比较两组患者年龄、BMI、手术时间、术前白蛋白水平,记录诱导丙泊酚、咪达唑仑及舒芬太尼剂量,记录入麻醉恢复室(PACU)时间、呕吐发生率、寒战发生率、呼吸抑制发生率、舌后坠发生率。结果:两组患者罗库溴铵起效时间、临床作用时间、恢复指数比较,差异无统计学意义(P> 0. 05);两组患者年龄、BMI、手术时间、术前白蛋白水平、3种诱导麻醉药剂量、入麻醉恢复室(PACU)时间、呕吐发生率、寒战发生率、呼吸抑制发生率、舌后坠发生率比较,差异亦无统计学意义(P> 0. 05)。结论:吸烟对成年男性患者全身麻醉手术罗库溴铵的临床作用时效及术后呼吸系统并发症发生率无明显影响。
Objective: To investigate the effect of rocuronium muscle relaxation during general anesthesia in adult male patients and postoperative complications such as retrolingual drop and respiratory depression. Methods: A total of 100 adult male patients with BMI18 ～ 22 kg/m2 and ASA grade Ⅰ ～Ⅱ,aged 20 to 60 years,who underwent urological surgery under general anesthesia,were divided into non-smoking group( group C) and smoking group( group S) according to whether they smoked or not.During anesthesia,TOF Watch instrument was used to monitor muscle relaxation and TOF( four strands of stimulation) was used to record and compare the onset time,clinical action time and recovery index of rocuronium in two groups of patients. Age,BMI,operation time,preoperative albumin level,dose of 3 inducedanesthetics,PACU,incidence of vomiting,shivering rate,respiratory inhibition rate and incidence of retrolingual drop were compared between the two groups. Results: The effective time,clinical action time and recovery index of rocuronium bromide were compared between the two groups,and the difference was not statistically significant( P > 0. 05). Age,BMI,operation time,preoperative albumin level,dose of 3 inducedanesthetics,PACU,incidence of vomiting,shivering rate,respiratory inhibition rate and incidence of retrolingual drop were compared between the two groups,and the difference was not statistically significant( P > 0. 05). Conclusion: Smoking has no significant effect on the clinical effect of rocuronium in adult male patients under general anesthesia and the incidence of postoperative respiratory complications.

关键词(KeyWords)： 吸烟;神经肌肉阻滞;罗库溴铵;全身麻醉;呼吸系统;并发症
smoking;neuromuscular block;rocuronium;general anesthesia;respiratory system;complication

Abstract:

Keywords:

基金项目(Foundation): 贵阳市科技计划项目[筑科合(20141001)44号]

作者(Author): 刘娜,王丰,周倩,高鸿,邹小华
LIU Na,WANG Feng,ZHOU Qian,GAO Hong,ZOU Xiaohua

DOI: 10.19367/j.cnki.1000-2707.2019.02.022

参考文献(References)：

• [1]PURVIS T E,RODRIGUEZ H J,AHMED A K,et al.Impact of smoking on post operative complications afteranterior cervical discectomy and fusion[J]. J Clin Neu-rosci,2017,38(4):106-110.
• [2]SAYYED K,VEE M L,ABDEL-RAZZAK Z,et al. Inhi-bition of organic anion transporter(OAT)activity by cig-arette smoke condensate[J]. Toxicol In Vitro,2017,44(6):27-35.
• [3]TAKANO M,NAKA R,SASAKI Y,et al. Effect of ciga-rette smoke extract on P-glycoprotein function in primarycultured and newly developed alveolar epithelial cells[J].Drug Metabolism&Pharmacokinetics,2016,31(6):417-424.
• [4]TURAN A,MASCHA E J,ROBERMAN D,et al. Smok-ing and perioperative outcomes[J]. Anesthesiology,2011,114(4):837-846.
• [5]WANG G Z,CHENG X,LI X C,et al. Tobacco smokeinduces production of chemokine CCL20 to promote lungcancer[J]. Cancer Lett,2015,363(1):60-70.
• [6]SCHMID M,SOOD A,CAMPBELL L,et al. Impact ofsmoking on perioperative outcomes after major surgery[J]. Am J Surg,2015,210(2):221-229.
• [7] REISLI R,APILLIOGULLARI S,REISLI I,et al. Theeffect of environmental tobacco smoke on the dose require-ments of rocuronium in children[J]. Paediatr Anaesth,2004,14(3):247-250.
• [8] NORTON M,XARD,PARENTE D,et al. Residualneuromuscular block as a risk factor for critical respiratoryevents in the post anesthesia care unit[J]. Rev EspAnestesiol Reanim,2013,60(4):190-196.
• [9]RAUTOMA P,SVARTLING N. Smoking increases the re-quirement for rocuronium[J]. Can J Anaesth,1998,45(7):651-654.
• [10]MEI Y,WANG S Y,LI Y,et al. Role of SLCO1B1,ABCB1,and CHRNA1 gene polymorphisms on the effica-cy of rocuronium in Chinese patients[J]. Journal of Clin-ical Pharmacology,2015,55(3):261-268.
• [11]KLOTH J S,KLMPEN H J,YU H,et al. Predictivevalue of cyp3a and abcb1 phenotyping probes for thepharmacokinetics of sunitinib:the clearsun study[J].Clinical Pharmacokinetics,2014,53(3):261-269.
• [12]FURUYA T,SUZUKI T,KASHIWAI A,et al. Theeffects of age on maintenance of intense neuromuscularblock with rocuronium[J]. Acta Anaesthesiol Scand,2012,56:236-239.
• [13]SAKURAI Y,UCHIDA M,AIBA J,et al. Effects ofpregnancy on the onset time of rocuronium[J]. The Jap-anese Journal of Anesthesiology,2014,63:324-327.

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