CAJ | 학술논문

目的筛选琥珀胆碱导致术后肌痛发生的危险因素.方法择期行头面部手术患者155例,年龄18～ 64岁,ASA分级Ⅰ或Ⅱ级,体重指数20～30 kg/m2.采用异丙酚全凭静脉麻醉或七氟醚静吸复合麻醉.根据术后24 h内是否发生肌痛分为2组:肌痛组和非肌痛组.收集患者性别、年龄、体重、手术时间、麻醉方法、琥珀胆碱剂量、麻醉诱导时是否预先注射利多卡因和非去极化肌松药、术中是否使用激素(地塞米松或甲强龙)和非甾体类镇痛药(帕瑞昔布钠)以及芬太尼用量等.将组间差异有统计学意义的因素进行多因素logistic回归分析,筛选琥珀胆碱导致术后肌痛发生的危险因素.结果 41例患者发生术后肌痛,发生率为27.2％.logistic回归分析结果显示:琥珀胆碱剂量＜ 1.5 mg/kg和未预先注射利多卡因是琥珀胆碱导致患者术后肌痛发生的独立危险因素(p＜0.01).结论琥珀胆碱剂量＜ 1.5 mg/kg和未预先注射利多卡因是琥珀胆碱导致患者术后肌痛发生的独立危险因素.
목적 사선호박담감도치술후기통발생적위험인소.방법 택기행두면부수술환자155례,년령18～ 64세,ASA분급Ⅰ혹Ⅱ급,체중지수20～30 kg/m2.채용이병분전빙정맥마취혹칠불미정흡복합마취.근거술후24 h내시부발생기통분위2조:기통조화비기통조.수집환자성별、년령、체중、수술시간、마취방법、호박담감제량、마취유도시시부예선주사리다잡인화비거겁화기송약、술중시부사용격소(지새미송혹갑강룡)화비치체류진통약(파서석포납)이급분태니용량등.장조간차이유통계학의의적인소진행다인소logistic회귀분석,사선호박담감도치술후기통발생적위험인소.결과 41례환자발생술후기통,발생솔위27.2％.logistic회귀분석결과현시:호박담감제량＜ 1.5 mg/kg화미예선주사리다잡인시호박담감도치환자술후기통발생적독립위험인소(p＜0.01).결론 호박담감제량＜ 1.5 mg/kg화미예선주사리다잡인시호박담감도치환자술후기통발생적독립위험인소.
Objective To determine the risk factors for development of succinylcholine-induced postoperative myalgia.Methods One hundred and fifty-five patients,aged 18-64 yr,of ASA physical status Ⅰ or Ⅱ,with body mass index of 20-30 kg/m2,scheduled for elective craniofacial surgery,were included in the study.Total intravenous anesthesia with propofol or combined intravenous-inhalational anesthesia with sevoflurane was performed during surgery.The patients were divided into 2 groups according to whether or not myalgia occurred within 24.h after surgery:myalgia group and non-myalgia group.Factors including gender,age,body weight,duration of surgery,method of anesthesia,dose of succinylcholine,preinjection of lidocaine or nondepolarizing muscular relaxants during induction of anesthesia,use of hormone (dexamethasone or methylprednisolone) and nonsteroidal analgesics (parecoxib sodium) during surgery,and consumption of fentanyl were recorded.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify the risk factors for development of succinylcholine-induced postoperative myalgia.Results Forty-one patients developed postoperative myalgia,and the incidence of myalgia was 27.2％.The results of logistic analysis indicated that succinylcholine ＜ 1.5 mg/kg and no preinjection of lidocaine were closely correlated with the development of postoperative myalgia induced by succinylcholine.Conclusion Succinylcholine＜1.5 mg/kg and no preinjection of lidocaine are the risk factors for development of succinylcholine-induced postoperative myalgia in the patients.