雷米芬太尼预注射对依托咪酯注射后肌阵挛的影响  

Effect of remifentanil pretreatment on myoclonus after etomidate injection

作　　者：马涛[1] 王维[1] 李冠华[1] 隋波[1] 张迎新[1] 

机构地区：[1]解放军第二炮兵总医院麻醉科,北京100088

出　　处：《中国医师进修杂志》2015年第2期100-102,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：目的 评价雷米芬太尼预注射对依托咪酯注射后肌阵挛的影响.方法 将60例择期行无痛肠镜检查患者按照随机数字表法分为雷米芬太尼组和对照组,每组30例.在缓慢静脉注射依托咪酯0.3 mg/kg前,雷米芬太尼组和对照组分别静脉注射雷米芬太尼0.5μg/kg或等量0.9％氯化钠.观察并记录肌阵挛发生情况及程度,同时观察患者有无恶心、瘙痒、呼吸暂停出现.结果 对照组发生肌阵挛22例（73.3％,22/30）,其中轻度11例,中度10例,重度1例.雷米芬太尼组发生肌阵挛2例（6.7％,2/30）,均为轻度.两组肌阵挛发生率比较差异有统计学意义（P＜0.01）.在对照组中,男性患者发生肌阵挛比例为14/16,女性患者为8/14.在雷米芬太尼组,男性与女性患者各有1例发生肌阵挛.雷米芬太尼组未发生恶心、瘙痒、呼吸暂停.结论 预注射雷米芬太尼0.5μg/kg可有效降低依托咪酯注射后肌阵挛的发生率,并且不会出现恶心、瘙痒、呼吸暂停等不良反应.男性注射依托咪酯肌阵挛的发生率较女性高.Objective To evaluate the effect of remifentanil pretreatment on myoclonus after etomidate injection.Methods Sixty patients undergoing scheduled for intestinal endoscopy under general anesthesia were divided into remifentanil group and control group by random digits table method with 30 cases each.Before 0.3 mg/kg etomidate was given,the patients in remifentanil group and control group were pretreated with remifentanil 0.5 μ g/kg or amount of 0.9% sodium chloride.Myoclonus was observed and recorded.Nausea,pruritis and apnea were observed after procedures.Results The incidence of myoclonus was 73.3%（22/30） in control group,mild in 11 cases,moderate in 10 cases and severe in 1 case.The incidence of myoclonus was 6.7%（2/30） in remifentanil group and mild in 2 cases.There was significant difference in the incidence of myoclonus between two groups （P 〈 0.01）.In control group,the ratio of myoclonus was 14/16 in males and 8/14 in females.In remifentanil group,male and female each had 1 case of myoclonus.There was no nausea,pruritis and apnea in remifentanil group.Conclusion Pretreatment with 0.5 μ g/kg remifentanil reduces myoclonus after etomidate injection,male patients are more associated with the incidence of myoclonus than female patients.

关 键 词：肌阵挛 依托咪酯 雷米芬太尼 

分 类 号：R614[医药卫生—麻醉学]