预注顺式阿曲库铵预防小儿依托咪酯全麻诱导引起肌阵挛的临床观察  

Pretreatment of cisatracurium reduces the frequency and severity of etomidate-induced myoclonus in children

作　　者：魏嵘[1,2] 章赛吉[1,2] 刘珺珺[1,2] 金泉英[1,2] 徐宝生[3] 

机构地区：[1]上海市儿童医院 [2]上海交通大学附属儿童医院麻醉科,上海200040 [3]南通大学第二附属医院麻醉科

出　　处：《南通大学学报（医学版）》2012年第6期498-500,共3页Journal of Nantong University(Medical sciences)

摘　　要：目的:观察预注顺式阿曲库铵防治小儿依托咪酯全麻诱导所引起肌阵挛的效果。方法:40例患儿随机分为2组,每组20例:Y组(预注组)预注顺式阿曲库铵0.01 mg/kg,生理盐水稀释到3 mL静脉推注;D组(对照组)静脉推注等量生理盐水3 mL,观察预注期间可能出现的不良反应并及时处理,2 min后各组分别推注依托咪酯0.3 mg/kg并观察肌阵挛分级情况,之后静脉给予顺式阿曲库铵0.1 mg/kg、咪达唑仑0.1 mg/kg、芬太尼2μg/kg,持续监测心电图、血压、血氧饱和度。结果:Y组与D组肌阵挛的发生率分别为60%和75%,差异无统计学意义(P>0.05);Y组肌阵挛程度评分与D组相比较差异亦无统计学意义(P>0.05)。预注期间Y组1例8岁男孩给予预注量顺式阿曲库铵1 min后出现轻度视物模糊,无其他明显不适,血压、心率及血氧饱和度无明显变化,认真观察未给予药物处理。结论:应用预注0.01 mg/kg顺式阿曲库铵的方法并不能有效减少儿童依托咪酯诱导所引起的肌阵挛的发生。Objective： To investigate the effect of pretreatment with a low dose of cisatracurium on the occurrence etomidate-induced myoclonus in children.Methods： 40 patients were randomly divided into two groups,each group included 20 cases.Patients were pretreated with a low dose of cisatracurium（0.01 mg/kg,group Y） or placebo（saline,group D）,follow two minutes later by etomidate（0.3 mg/kg）,after two minutes,anesthesia was induced with cisatracurium 0.1 mg/kg,midazolam 0.1 mg/kg,fentanyl 2 μg/kg.Electrocardiogram（ECG）,blood pressure（BP） and pulse oximetery（SpO2） were recorded continuously throughout the procedure.The occurrence and severity（score 0-3） of myoclonus was defined.Results： No difference in the occurrence or severity of myoclonus was found between Group Y（60%） and Group D（75%）（P0.05）.One eight years old boy in Y group appeared light blurred vision,without other obvious discomfort.Conclusion： The use of 0.01 mg/kg cisatracurium as priming dose did not influence the incidence of myoclonus after induction of anaesthesia with etomidate in children.

关 键 词：肌阵挛 预注 顺式阿曲库铵 依托咪酯 小儿 

分 类 号：R971.8[医药卫生—药品]