Observation On The Effect Of Cis-atracurium At Different Dose In General Anesthesia For Obese Children

Objective:To observe the muscle relaxation effect of different doses of cisatracurium in the process of general anesthesia for intubation in obese children,to verify the existence of ceiling effect,and to explore the appropriate anesthesia induction dose in obese children,so as to better implement accurate anesthesia under the guidance of ERAS concept,and to provide clinical reference for the rational use of muscle relaxation drugs in obese children.Methods:45 obese children(according to the BMI reference standard of children)with ASA I-? grade,aged between 3 to 10 years old,were selected for surgery under total intravenous anesthesia.Patients were randomly divided into three groups: A,B and C,group a received cisatracurium 0.10mg/kg during anesthesia induction,group B received cisatracurium 0.15mg/kg during anesthesia induction,and group C received cisatracurium 0.20mg/kg during anesthesia induction.The other anesthesia induction drugs and administration sequence of the three groups were the same.During the operation,the condition score of tracheal intubation(Cooper's score)and the muscle relaxation of adductor pollicis were monitored.The monitoring indexes of muscle relaxation recorded included:(1)onset time(the time from administration to the maximum inhibition of T1);(2)clinical effect time(the time from administration to the recovery of T1 to 25%);(3)recovery index(the time from 25% to 75%).Results:1.There was no significant difference between the three groups in generaldata such as gender,BMI,age,ASA grade(P > 0.05).2.There was no significant difference between the three groups(P >0.05).3.There was no significant difference in heart rate and mean arterial pressure among the three groups(P > 0.05).4.Compared with group A,the onset time of group B and group C was significantly shorter,the difference was statistically significant(P < 0.05),but there was no significant difference between group C and group B(P > 0.05);compared with group A,the clinical effect time of group B and group C was significantly longer,The difference was statistically significant(P < 0.05),and the clinical effect time of group C was longer than that of group B,the difference was statistically significant(P < 0.05);there was no statistical significance in the recovery index of the three groups(P > 0.05).Conclusion:When obese children apply cisatracurium according to the ideal weight,there is a "ceiling effect" on the muscle relaxation effect during induction.,the ceiling dose is 0.2 mg / kg,which is 4 times the ED95.When obese children apply cisatracurium according to the ideal weight according to the ideal body weight,the reasonable induction dose is 0.15 mg / kg,which is three times the ED95.