Effects Of Different Degrees Of Muscle Relaxation On Rigid Bronchoscopic Airway Stenting In Patients With Lung Cancer

Objective: To investigate the effect of deep muscle relaxation versus moderate muscle relaxation on rigid bronchoscopic airway stenting in patients with lung cancer under the guidance of muscle relaxation monitor.Methods: Forty patients with lung cancer who needed rigid t bronchoscopic airway stenting during elective operation were randomly divided into two groups: deep muscle relaxation group(group D)and moderate muscle relaxation group(group M),with 20 cases in each group.All patients were treated with total intravenous anesthesia and jet ventilation.Under the guidance of muscle relaxation detector,the degree of muscle relaxation was controlled and regulated by single injection combined with continuous infusion of cis atracurium to maintain muscle relaxation in each group: group D,PTC1-2;group M,TOF1-2.Group records: muscle relaxation related intubation(intubation time,intubation condition score);use of muscle relaxation(average usage of muscle relaxation,additional times of muscle relaxation);recovery of muscle relaxation after drug withdrawal(TOFr0.1 recovery time,T125%-75 %recovery time,TOFr0.1-0.9 recovery time,extubation immediately TOFr);complications within 24 hours after extubation(PACU stay time extension,upper respiratory tract obstruction,postoperative reintubation).Preoperative general condition(sex,age,BMI,ASA grade,LEMON score),operation-related parameters(operation and anesthesia time,intraoperative hemodynamic changes).Results: The intubation time in group D was shorter than that in group M,and the intubation condition was better in group D(P < 0.05).The average amount of muscle relaxation in group D was higher than that in group M(P < 0.05),and the number of times of additional muscle relaxation in group D was less than that in group M(P < 0.05).There was no significant difference in TOFr0.1-0.9 recovery time between the two groups(P >0.05).The TOFr0.1 recovery time in group and the T125%-75 %recovery time,group D was longer than that in group M(P < 0.05),and the TOFr at extubation in group D was higher than that in group M(P< 0.05).There was no significant difference in postoperative PACU stay time between the two groups,and there was no upper respiratory tract obstruction or re-intubation after operation.There was no significant difference in sex,age,BMI,ASA grade and LEMON score between the two groups.There was no significant difference in anesthesia time and operation time between the two groups(P >0.05).There was no significant difference in mean arterial pressure((MAP))and heart rate((HR))between the two groups at each time point.Conclusion: Deep muscle relaxation can be used in rigid bronchoscopic airway stenting in patients with lung cancer.Under the guidance of muscle relaxation monitor,deep muscle relaxation is more favorable for rigid bronchoscopic stent implantation in patients with lung cancer than moderate muscle relaxation,which shortens the time of rigid bronchoscopy intubation,optimizes intubation conditions,and provides a more controllable degree of muscle relaxation.and does not increase the risk associated with muscle relaxation.