Effect Observation Of Different Doses Of Rocuronium Bromide In Short Operation Of Preschool Children

Objective: To study the effects of different doses of rocuronium bromide on intubation response,respiratory system,circulatory system,postoperative recovery and surgeon satisfaction during short operations in preschool children,so as to find a basis for selecting a more suitable dose of rocuronium bromide for this group.Methods: According to the schedule of elective surgery in our hospital,a total of 90 pre-school children who underwent almond and adenoid resection in otolaryngology department from January 2022 to December 2022 were collected and divided into three groups(n=30)by random number table method,which were low-dose group: Group L;Medium dose group: M group;High dose group: Group H.Group L was given 1 times ED95 rocuronium bromide(0.3mg/kg),group M was given 1.5 times ED95 rocuronium bromide(0.45mg/kg),and group H was given 2 times ED95 rocuronium bromide(0.6mg/kg).The heart rate(HR),blood pressure(BP),oxygen saturation(Sp O2),end-breath carbon dioxide(PETCO2),peak airway pressure before anesthesia(T0),induction(T1),intubation(T2),mouth opener placement(T3),withdrawal(T4),extubation(T5),and 5 minutes after extubation(T6)Volume/(peak airway pressure-PEEP)];TOFr values immediately after loss of consciousness,30 seconds between loss of consciousness and the start of surgery,and 5 minutes after the start of surgery were recorded.The time from drug withdrawal to recovery of spontaneous respiration and the time from recovery of spontaneous respiration to extubation were recorded in the three groups.Intubation reaction,intraoperative swallowing activity,postoperative respiratory complications(postlingual fall,laryngeal spasm,choking,etc.)were recorded in the three groups.The dosage of sedative and analgesic drugs during induction and maintenance were recorded in the three groups.According to the TOFr value shown by the muscle relaxation monitor,the three groups of children requiring muscle relaxation antagonists were recorded.Results:1.Tracheal intubation and operation could be carried out successfully with different doses of rocuronium bromide in the three groups.Intraoperative hemodynamic and respiratory mechanical parameters were stable,and BIS was within the normal range at all periods;2.For the same preoxygenation time,intubation conditions of group L were inferior to those of the other two groups.The muscle release monitor showed that the time required for TOFr value > 70 in group H was significantly longer than that in the other two groups,the number of children who needed to be given muscle release antagonist after surgery was more than that in the other two groups,and the postoperative recovery and extubation time was also significantly longer than that in the other two groups.3.The incidence of respiratory complications in group L was significantly higher than that in the other two groups;4.The surgeon indicated that the dose of medication in group L affected the operation,and there was no difference in the satisfaction between group M and group H.Conclusion: 0.45mg/kg rocuronium bromide used in pediatric amygdalloidectomy can not only provide good conditions for endotracheal intubation,but also facilitate the operation of surgeons.In addition,intraoperative hemodynamic fluctuation is small,postoperative recovery and extubation are safe and rapid,improve the turnover rate of operating room,shorten the length of hospital stay,and reduce medical costs.It conforms to the fast channel anesthesia technique principle advocated by modern anesthesia.