依托咪酯在心房纤颤直流同步电复律术中的应用  

Application of etomidate in synchronized direct current cardioverter in atrial fibrillation

作　　者：苗俊东[1] 孙晓斐[1] 艾克木 郝丽[1] 张凤兰 刘建敏 

机构地区：[1]山东省济宁市第一人民医院心内科,272111 [2]喀什卫校附院

出　　处：《中国心血管病研究》2005年第1期63-65,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的观察依托咪酯在心房纤颤直流同步电复律术中诱导睡眠的效果及安全性。方法将心房纤颤住院性电复律的患者共计127例,分为二组:依托咪酯组和地西泮组。其中依托咪酯84例,地西泮组43例。诱导睡眠方法:依托咪酯组:依托咪酯20mg(10ml)静脉缓注,至入深睡眠状态,停止注射,记录用药剂量;地西泮组:地西泮20mg静脉缓注至深睡眠状态,无效则逐渐增加地西泮量至入深睡眠状态。观察药物剂量、诱导睡眠时间、复律后清醒时间、复律时心律失常、复律成功率、不良反应(如抽动,呼吸抑制,谵妄,喉部痉挛、静脉炎等)。结果依托咪酯与地西泮对患者复律前后血压心率影响无差异,依托咪酯诱导睡眠时间(3.90±1.26)min远短于地西泮组(13.07±3.41)min,二组比较P<0.001。复律后清醒时间(5.44±2.37)min远短于地西泮组(28.75±13.62)min,二组比较P<0.001,依托咪酯组静脉炎发生率(1.2%)明显低于地西泮组(20.9%),二组比较P<0.001。依托咪酯组抽动7例(8.4%),未经处理观察2min后自行消失。结论依托咪酯用于心房纤颤直流同步电复律术中诱导睡眠时快速有效,作用时间及恢复时间短,安全性高。Objective To observe the effect and reliability of sleeping inducing of etomidate in synchronized direct current cardioverter in atrial fibrillation patients. Methods 127 hospitalized patients with atrial fibrillation in our hospital from October 1996 to October 2003 were divided into 2 groups by the sleeping inducing.etomidate group with 84 patients and sonacon group with 43 patients.methods of sleeping inducing in the etomidate group:etomidate 20mg(10ml) were given by vein injection slowly till patients were in deep sleep and the dosages of the agents were recorded.methods of sleeping inducing in the sonacon group.sonacon 20mg were given by vein injection slowly till patients were in deep sleep,added the dosage gradually if it was inefficient.The dosages of the two drugs,the time of sleeping inducing,the awake time after cardioverter,arrythmia while the cardioverter,the success rate of the cardioverter,the mal-response(such as tic,respiratory depression,agitated,spasmus of the throat,phlebitis,et al).were recorded. Result The influences of blood pressure and heart rate before and after cardioverter showed no difference between etomidate group and sonacon group.the time of sleeping inducing was obviously shorter in etomidate group(3.90±1.26min) than in sonacon group(13.07±3.41min),P<0.001.the awake time after cardioverter was obviously shorter in etomidate group(5.44±2.37min) than in sonacon group(28.75013213.62min),P<0.001.the incidence rate of phlebitis was obviously lower in etomidate group(1.2%) than in sonacon group(20.9%),P<0.001.there were more tics in etomidate group(8.4%),which disappeared automatically after 2 minutes' observation without any treatment. Conclusion Etomidate with short action time and recovery time,high reliability can induce sleeping quickly and efficiently in synchronized direct currentcardioverter in atrial fibrillation patitents.

关 键 词：依托咪酯 心房纤颤 直流电复律 诱导睡眠 清醒时间 复律后 

分 类 号：R541.75[医药卫生—心血管疾病]