The Clinical Use Of Closed-loop Muscle Relaxant Injection System In Traditional Laparotomy

Objective:To research clinical safety and superiority of Closed-loop Muscle Relaxant Injection System(CLMRIS)in traditional laparotomy.Methods:90 patients under total intravenous anesthesia,with ASA class I~II,aged30~75,operation time more than 100 min,BMI 18~24,were selected.And the exclusion criteria were preoperative pulmonary dysfunction,liver and renal dysfunction,and cardiovascular disease;trauma or an operation at the position where monitored within three months;history of alcoholism or drug abuse;electrolyte disturbance(potassium,calcium,magnesium,etc);drugs which can affect the function of neromuscular trasmission;communication barriers and so on.Patients were randomly divided into three groups:E group received by CLMRIS,C group received by experience and E+C group combined CLMRIS with exprience.Starting(t1),tracheal intubation(t2),cutting skin(t3),seeming skin(t4),stopping operation(t5),spontaneous breathing recovery(t6),consciousness recovery(t7)and etubation(t8)were recorded.Theindexes were compared between three groups:T1 rate,TOF rate,onset time,intubation time,induction dosage,Copper ratings,total dosage,duration of surgery,duration of anaesthesia,recovery time,recovery index,Riker` sedation agitation scale,satisfaction scores of surgeon and anesthesiologist,and adverse reactions.Results:All groups were able to meet the requirements of muscle relaxation,there were no difference(P>0.05)in general situation,onset time,adding frequency,recovery index.Compared with group C,intubation time of E group and E+C group were longer,but Copper ratings of these two groups were higher,with more effective intubation during induction of anesthesia.During the maintenance of anesthesia,E group used more vecuronium than the other two groups,and the average infusion speed of vecuronium was more faster,but with fewer adverse reactions.After surgery,compared with E+C group and C group,E group had less time in recovring from anesthesia,and had higher value of TOF after extubation.The duration time of PACU was also lower at E group.Conclusion:CLMRIS has obvious advantages in terms of ensuring smooth and effective muscle relaxant requirements,safety during extubation and postoperative recovery.Muscle relaxants administered through CLMRIS can be safely used in clinical traditional laparotomy under total intravenous anesthesia.Using CLMRIS can reduce the workload of anesthesiologist and improve the efficiency of clinical work.