不同静脉麻醉药对罗库溴胺快速诱导气管插管的影响  

Effect of Different Intravenous Anesthetics on Rapid Induciag Endotracheal Intubation with Rocuronium

作　　者：夏登云[1] 赵永泉[1] 

机构地区：[1]河北北方学院附属第一医院麻醉科,河北张家口075000

出　　处：《河北北方学院学报（医学版）》2007年第3期25-28,共4页Journal of Hebei North University:Medical Edition

基　　金：河北省科学技术研究与发展指导计划项目(编号:062761184)

摘　　要：目的：观察硫贲妥钠、依托咪酯以及异丙酚麻醉诱导对罗库溴铵的插管条件和神经肌肉阻滞程度的影响。方法：选择39例全麻择期手术患者,ASAⅠ-Ⅱ级,随机分为三组,分别采用硫贲妥钠5.0mg·kg^-1、依托咪酯0.3mg·kg^-1及异丙酚1.5-2.0mg·kg^-1静脉诱导,静注罗库溴铵60s后行气管插管。记录气管插管即刻的T1和T4/T1值、插管时间,记录血流动力学参数变化、脉搏血氧饱和度,根据气管插管评分标准进行插管评分。结果：各组病人气管插管即刻的T1和T4/T1及插管时间组间比较无明显差异（P〉0.05）,三组病人在静注罗库溴铵后60s气管插管条件综合评分均为优良（P〉0.05）,但是依托咪酯比硫贲妥钠和异丙酚气管插管反应略少。结论：依托咪酯伍用罗库溴铵在静注后60s行快速诱导插管略优于硫贲妥钠和异丙酚。如果患者禁忌使用琥珀胆碱可以改用依托咪酯与罗库溴铵来完成快速诱导和气管插管。Objective： To investigate the influence of thiopentone, etomidate and propofol for rapid intubation with rocuronium. Methods.. Thirty-nine patients with ASAⅠ-Ⅱ were randomly divided into three groups. Anesthesia was induced separately with midazolam 2mg, fentanyl 2μg ·kg^-1 followed by thiopentone 5.0mg·kg^-1 （T-group; n=13）, etomidate 0.3mg·kg^-1（E-group; n=13） or propofol 1.5-2.0 mg·kg^-1（P-group; n=13）. All patients in three groups were administered 0.6 mg·kg^-1 Laryngoscopy was administrated 60s later and intubation conditions were evaluated according to a standard score, which would express easiness for laryngoscopy, condition of the vocal cords and reaction to intubation. Neuromuscular transmission was assessed at the adductor pollicis muscle using the TOF-GUARD monitor. Results： Excellent and good intubation conditions were obtained in all three groups （P〉0.05）. Diaphragmatic response marked less in the etomidate group compared with that of thiopentone and propofol groups. The degree of neuromuscular block [% decrease of T1, mean（SD）] at the time of intubation was similar： etomidate group 29.23（13.47）% thiopentone group 28.46（15.24） %, propofol group 24. 38（9.47） %. Conclusion： Etomidate 0.3mg·kg^-1as part of regimen for rapid inducing endotracheal intubation with rocuronium attenuateds the reaction to a greater extend than thiopentone or propofol.

关 键 词：依托咪酯 硫贲妥钠 异丙酚 罗库溴铵 快速诱导插管术 

分 类 号：R614.24[医药卫生—麻醉学]