Tỷ lệ tồn dư thuốc giãn cơ rocuronium sau phẫu thuật nội soi ổ bụng

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Tác giả: Minh Nhựt Đoàn, Thị Mỹ Xuyên Nguyễn, Văn Chinh Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y Dược học Phạm Ngọc Thạch, 2024

Mô tả vật lý: tr.77

Bộ sưu tập: Báo, Tạp chí

ID: 286325

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Đặt vấn đề: Tồn dư thuốc giãn cơ là nguy cơ gây ra biến chứng sau phẫu thuật cho người bệnh, đặc biệt là phẫu thuật nội soi ổ bụng. Nghiên cứu nhằm xác định tỷ lệ tồn dư thuốc giãn cơ rocuronium sau phẫu thuật nội soi ổ bụng. Đối tượng và phương pháp nghiên cứu: Nghiên cứu cắt ngang mô tả được thực hiện trên 92 người bệnh được phẫu thuật nội soi ổ bụng, tại khoa Gây mê hồi sức, Bệnh viện Nguyễn Tri Phương. Theo dõi tồn dư thuốc giãn cơ rocuronium thông qua chỉ số TOF (train of four) bằng máy kích thích thần kinh cơ TOF-watch tại các thời điểm: trước khi sử dụng thuốc hóa giải giãn cơ, khi rút ống nội khí quản và sau rút ống nội khí quản 15 phút, 30 phút, 60 phút, 90 phút và 120 phút. Kết quả: Tỷ lệ tồn dư thuốc giãn cơ rocuronium (TOF <
0,9) sau phẫu thuật nội soi ổ bụng tại các thời điểm: trước khi sử dụng thuốc hóa giải giãn cơ, khi rút ống nội khí quản và sau rút ống nội khí quản 15 phút, 30 phút, 60 phút, 90 phút lần lượt là 100%
53,3%
10,9%
8,7%
3,3% và 0%. Kết luận: Tỷ lệ người bệnh có tồn dư thuốc giãn cơ rocuronium sau phẫu thuật nội soi ổ bụng là tương đối cao và giảm dần theo thời gian. Cần theo dõi, nhận biết, đánh giá sớm nguy cơ tồn dư thuốc giãn cơ sau phẫu thuật nhằm giảm nguy cơ, biến chứng cho tồn dư thuốc gây ra và nâng cao chất lượng hồi tỉnh cho người bệnh.Abstract Background/Objectives: Residual neuromuscular blockade is a risk of postoperative complications for patients, especially laparoscopic surgery. This study aimed to determine the rate of residual residual neuromuscular blockade with rocuronium after laparoscopic surgery. Methods: A cross-sectional descriptive study was conducted on 92 patients undergoing laparoscopic surgery in the Department of Anesthesia and Resuscitation, Nguyen Tri Phuong Hospital. The residual neuromuscular blockade was monitored using the TOF (train of four) index with the TOF-watch nerve stimulator at the following time points: before the use of the antagonisation, at the time of extubation, and 15, 30, 60, 90, and 120 minutes after extubation. Results: The rate of residual residual neuromuscular blockade with rocuronium (TOF <
0.9) after laparoscopic surgery at the following moments: before the use of antagonisation, extubation, and 15, 30, 60, 90 minutes after extubation were 100%
53.3%
10.9%
8.7%
3.3% and 0%. Conclusion: The rate of residual residual neuromuscular blockade with rocuronium after laparoscopic surgery is relative high and reduces over time. It is necessary to monitor, recognize and assess early the residual paralysis after surgery to reduce the risk and complication for improving the quality of recovery for the patients. DOI: 10.59715/pntjmp.3.4.10

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