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題名 | Intubation Conditions with Low Dose Rocuronium under Sevoflurane Induction for Children=兒童在Sevoflurane誘導麻醉下使用低劑量Rocuronium之插管狀況 |
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作者姓名(中文) | 洪銚辰; 施明宏; 石智仁; 劉雪金; 高宜娟; 陳捷; 黃潔文; | 書刊名 | 長庚醫學 |
卷期 | 28:3 2005.03[民94.03] |
頁次 | 頁174-179 |
分類號 | 417.662 |
關鍵詞 | 小兒麻醉; Sevoflurane誘導麻醉; 插管狀況; Pediatric anesthesia; Rocuronium; Sevoflurane induction; Intubation condition; |
語文 | 英文(English) |
中文摘要 | Backgorund: During short surgical procedures and when there is a need to avoid the use of anticholinesterase at the end of surgery, the use of a smaller intubation dose of neuromuscular blocking drug is preferred. The aim of this study was to evaluate tracheal intubation conditions using smaller doses of rocuronium for children under sevoflurane induction. Methods: Eighty American Society of Anesthesiologists classification physical status I or II children were enrolled. After mask induction with sevoflurane with nitrous oxide for 3 minutes, 0.3mg/kg of rocuronium was given. Intubation was performed 60 or 90 seconds thereafter. Study group A included children aged 1 to 3 years and 90 seconds between rocuronium injection and intubation. Group B included children aged 1 to 3 years who had 60 seconds between rocuronium injection and intubation. Group C included children aged 4 to 6 years who had 90 seconds between rocuronium injection and intubation. Group D included children aged 4 to 6 years who had 60 seconds between rocuronium injection and intubation. Intubation conditions were judged based on the scoring of ease of jaw opening and laryngoscopy, position of the vocal cords, and degree of straining after tracheal intubation. Results: All 80 children underwent successful tracheal intubation without laryngospasm or any complications. Intubation conditions were judged as optimal in all children in group A, 95% in group B, 80% in group C, and 65% in group D. Conclusions: A total of 0.3mg/kg of rocuronium was sufficient for tracheal intubation for children 1 to 6 years old under sevoflurane induction. To guarantee optimal intubation conditions for elder children, allow 90 seconds waiting time after rocuronium administration was recommended. |
英文摘要 | 背景:在較短手術或不宜使用抗膽鹼酯酵素之情況下,宜選用較低插管劑量之肌肉鬆弛劑,本試驗目的為評估兒童在sevoflurane誘導麻醉下使用低劑量rocuronium之氣管內插管狀況。 方法:本試驗收入80位麻醉危險分類一或二級的兒童,將之依年齡(1~3歲或4~6歲)和給藥後插管時間(60秒或90秒)分成A-D四組。所有兒童以面罩給予吸入性麻醉藥誘導,三分鐘後從靜脈點滴注射rocuronium 0.3mg/Kg,給藥後60秒或90秒進行氣管內管插管。A組為1到3歲,給藥後至插管時間90秒;B組為1到3歲,給藥後至插管時間60秒;C組為4到6歲,給藥後至插管時間90秒;D組為4到6歲,給藥後至插管時間90秒。以下頜骨打開的難易度、聲帶位置和插管後腹肌動作評估插管狀況為理想、良好及失敗。 結果:所有兒童都接受成功插管,沒有任何併發症。A組兒童全部達到理想插管狀況,B組有95%,C組80%,D組65%。 結論:對於1到6歲的兒童,在sevoflurane麻醉誘導下rocuronium 0.3mg/Kg可提供足夠的插管劑量。對於年齡較大的兒童,建議給藥後等90秒可有較理想插管狀況。 |
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