【摘要】 目的 探讨罗库溴铵在小儿疝气全身麻醉手术中的应用效果。方法 采用前瞻性对照研究设计，选取2023年4月至2024年9月于郑州市中心医院就诊的疝气患儿100例，按照随机数字表法将其分为常规麻醉组（n=50）和罗库溴铵组（n=50）。常规麻醉组使用顺阿曲库铵进行麻醉，罗库溴铵组使用罗库溴铵进行麻醉。比较常规麻醉组和罗库溴铵组肌松效果、肌松时效、血流动力学、应激反应与术后不良反应。结果 罗库溴铵组的肌松药物维持时间（53.18±6.68）min长于常规麻醉组（41.90±5.04）min（t=9.532,P<0.05）；自主呼吸时间、指令性睁眼时间、恢复室时间以及四个成串刺激起效时间[（5.38±0.93）min、（17.28±2.15）min、（30.96±3.63）min、（154.84±21.35）s]均短于常规麻醉组[（8.13±1.12）min、（23.25±2.76）min、（36.37±4.15）min、（183.32±20.56）s]，差异有统计学意义（t=13.357、12.066、6.938、6.794，均P<0.05）；麻醉后，罗库溴铵组的心率[（91.15±10.46）次/min]低于常规麻醉组[（98.81±10.72）次/min]，差异有统计学意义（t=3.616,P<0.05），平均动脉压[（82.14±8.20）mmHg（1 mmHg=0.133 kPa）]高于常规麻醉组[（76.88±7.78）mmHg]，差异有统计学意义（t=3.290,P<0.05）；罗库溴铵组不良反应发生率[10.00%（5/50）]与常规麻醉组[14.00%（7/50）]差异无统计学意义（χ²=0.379,P>0.05）；麻醉开始时（T₁）、手术开始30 min时（T₂）与手术结束时（T₃）时，罗库溴铵组的肾上腺素[（47.98±5.53）、（54.73±4.91）、（43.17±5.64）ng/L]与去甲肾上腺素水平[（151.84±16.48）、（162.54±18.35）、（148.36±16.19）ng/L]均低于常规麻醉组[（52.47±5.58）、（58.62±5.96）、（46.59±5.76）ng/L,（159.11±16.86）、（171.95±19.38）、（161.72±18.24）ng/L]，差异均有统计学意义（t=4.041、3.277、3.000、2.180、2.493、3.873，均P<0.05）。结论 罗库溴铵在小儿疝气全身麻醉手术中的应用效果较好，肌松效果更佳，可缓解机体应激反应，安全性良好。更多还原

【Abstract】 Objective To explore the efficacy of rocuronium in general anesthesia for pediatric hernia surgery. Methods A prospective randomized controlled trial was conducted. A total of 100 pediatric patients with hernia admitted to Zhengzhou Central Hospital from April 2023 to September 2024 were selected and divided into the conventional anesthesia group（n=50） and the rocuronium group（n=50） according to the random number table method. The conventional anesthesia group received cisatracurium for anesthesia, while the rocuronium group was anesthetized with rocuronium. The muscle relaxation effect, duration of muscle relaxation, hemodynamics, stress response, and postoperative adverse reactions were compared between the two groups. Results The maintenance time of muscle relaxants in the rocuronium bromide group（（53.18±6.68） min） was longer than that in the conventional anesthesia group（（41.90±5.04） min）（t=9.532, P<0.05）. The times to spontaneous respiration, eye opening on command, required stay in the recovery room, and onset of train-of-four stimulation（（5.38±0.93） min,（17.28±2.15） min,（30.96±3.63） min,（154.84±21.35） s） were shorter than those in the conventional anesthesia group（（8.13±1.12） min,（23.25±2.76） min,（36.37±4.15） min,（183.32±20.56） s）, and the differences were statistically significant（t=13.357, 12.066, 6.938, 6.794, all P<0.05）. After anesthesia, the heart rate in the rocuronium bromide group（（91.15±10.46） beats/min） was lower than that in the conventional anesthesia group（（98.81±10.72） beats/min）, and the difference was statistically significant（t=3.616, P<0.05）, The mean arterial pressure in the rocuronium bromide group（（82.14±8.20） mmHg）（1 mmHg=0.133 kPa） was higher than that in the conventional anesthesia group（（76.88±7.78） mmHg）, and the difference was statistically significant（t=3.290, P<0.05）. There was no statistically significant difference in the incidence of adverse reactions between the rocuronium group and the conventional anesthesia group（10.00%（5/50） vs 14.00%（7/50）, χ²=0.379, P>0.05）. At the onset of anesthesia（T₁）, 30 minutes after surgery began（T₂）, and at the end of surgery（T₃）, the levels of adrenaline and noradrenaline in the rocuronium group were lower than those in the conventional anesthesia group（（47.98±5.53） ng/L vs（52.47±5.58） ng/L,（54.73±4.91） ng/L vs（58.62±5.96） ng/L,（43.17±5.64） ng/L vs（46.59±5.76） ng/L;（151.84±16.48） ng/L vs（159.11±16.86） ng/L,（162.54±18.35） ng/L vs（171.95±19.38） ng/L,（148.36±16.19） ng/L vs（161.72±18.24） ng/L, respectively）, with statistically significant differences（t=4.041, 3.277, 3.000, 2.180, 2.493, 3.873, all P<0.05）. Conclusion Rocuronium demonstrates favorable efficacy in general anesthesia for pediatric hernia surgery. It provides better muscle relaxation, alleviates the body’s stress response, and exhibits a good safety profile.更多还原