A retrospective study of cisatracurium besilate-assisted treatment of severe acute pancreatitis complicated with intraabdominal hypertension
10.3760/cma.j.cn131073.20211227.00518
- VernacularTitle:苯磺顺阿曲库铵辅助治疗重症急性胰腺炎合并腹内高压的回顾性分析
- Author:
Na LI
1
;
Yanfang ZHANG
;
Shasha LIU
;
Zilei XIE
;
Rui MU
;
Yuan ZHANG
;
Jianbo YU
Author Information
1. 天津医科大学南开临床学院 天津市南开医院麻醉科和重症医学科，天津 300100
- Keywords:
Atracurium;
Pancreatitis;
Intra-abdominal hypertension
- From:
Chinese Journal of Anesthesiology
2022;42(5):591-594
- CountryChina
- Language:Chinese
-
Abstract:
The clinical data of patients with severe acute pancreatitis complicated with intraabdominal hypertension or abdominal compartment syndrome admitted to our Department of Critical Care Medicine from January 1, 2018 to October 1, 2021 were collected and analyzed.Patients were divided into a conventional treatment group and conventional treatment plus IV infusion of cisatracurium besilate group (muscle relaxation group). A prediction model of treatment propensity score was developed for paired screening, with 31 cases in each group.The conventional treatment group adopted conventional basic treatment methods such as gastrointestinal decompression, spasmolysis and analgesia, fluid therapy, inhibition of gastric acid, suppression of parenzyme, nutritional support, mechanical ventilation, and enemata.In muscle relaxation group, cisatracurium besilate was intravenously infused on the basis of routine treatment with the initial dose of 0.15 mg/kg given to facilitate endotracheal intubation, followed by continuous intravenous infusion at 1-3 μg·kg -1·min -1, and the dose was adjusted according to the patient′s basic vital signs and clinical effects.The primary outcome was survival rate.Secondary outcome measures were changes in intraabdominal pressure, oxygenation index, the number of defecation, volume of defecation, and urination volume before treatment and on 7, 14 and 20 days of treatment.and the recovery time of bowel sounds, length of mechanical ventilation, time of intensive care unit treatment, and total hospitalization costs.Compared with conventional treatment group, the survival rate was significantly increased, the intraabdominal pressure was decreased on 7, 14 and 20 days of therapy, the oxygenation index was increased, the number of defecation and volume of defecation were increased on 7 and 14 days of therapy, urinary volume was increased before treatment and on day 7 of therapy, the recovery time of intestinal sound was significantly shortened ( P<0.05), and no significant change was found in urinary volume on days 14 and 20 of therapy, length of ventilation, time of intensive care unit treatment, and total hospitalization costs in muscle relaxation group ( P>0.05). In conclusion, cisatracurium besilate can improve oxygenation, promote the recovery of intestinal function and improve the survival rate when used to assist the treatment in the patients with severe acute pancreatitis complicated with intraabdominal hypertension.
