布托啡诺、咪达唑仑单独或复合用药预防麻醉诱导时依托咪酯诱发患者肌阵挛效果的比较  

Comparison of butorphanol or midazolam alone and combination of the two drugs in preventing etomidate-induced myoclonus during anesthesia induction

作　　者：张婧[1,2] 刘玲[1] 刘和平[1] 吕国义[1] 

机构地区：[1]北京丰台右安门医院麻醉科 [2]天津医科大学第二医院麻醉科,300211

出　　处：《中华麻醉学杂志》2015年第11期1325-1327,共3页Chinese Journal of Anesthesiology

摘　　要：目的 比较布托啡诺、咪达唑仑单独或复合用药预防麻醉诱导时依托咪酯诱发患者肌阵挛的效果.方法 择期全麻手术患者160例,年龄40～64岁,体重指数20～ 25 kg/m2,ASA分级Ⅰ或Ⅱ级,采用随机数字表法分为4组（n=40）：对照组（C组）、布托啡诺组（B组）、咪达唑仑组（M组）和布托啡诺复合咪达唑仑组（BM组）.麻醉诱导前,B组经30 s静脉注射布托啡诺15.0 μg/kg,M组经30 s静脉注射咪达唑仑50 μg/kg,BM组经30 s静脉注射布托啡诺7.5 μg/kg和咪达唑仑25μg/kg,C组静脉注射等容量生理盐水.2 min后,经1 min静脉注射依托咪酯脂肪乳剂0.3 mg/kg.记录静脉注射依托咪酯后2 min内肌阵挛的发生情况,并评价其程度.结果 与C组比较,B组、M组和BM组肌阵挛发生率和程度降低（P＜0.05）;与B组和M组比较,BM组肌阵挛发生率和程度降低（P＜0.05）;B组和M组肌阵挛发生率和程度比较差异无统计学意义（P＞0.05）.结论 布托啡诺和咪达唑仑预防麻醉诱导时依托咪酯诱发患者肌阵挛的效果相当,二者复合应用的效果优于单独应用.Objective To compare butorphanol or midazolam alone and combination of the two drugs in preventing etomidate-induced myoclonus during anesthesia induction.Methods One hundred sixty patients, aged 40-64 yr, with body mass index of 20-25 kg/m2, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , scheduled for elective operations under general anesthesia, were randomly allocated into 4 groups with 40 patients in each group： control group （group C）, butorphanol group （group B） , midazolam group （group M） , and butorphanol combined with midazolam group （group BM）.Before induction of anesthesia, butorphanol 15.0 μg/kg, midazolam 50 μg/kg, and butorphanol 7.5 μg/kg combined with midazolam 25 μg/kg were injected intravenously over 30 s in B, M and BM groups, respectively.The equal volume of normal saline was given in group C.And 2 min later, etomidate 0.3 mg/kg was injected intravenously over 1 min.The occurrence of myoclonus was recorded within 2 min after administration of etomidate, and the severity of myoclonus was assessed.Results Compared with group C, the incidence and severity of myoclonus were significantly decreased in B, M and BM groups （P〈0.05）.Compared with B and M groups, the incidence and severity of myoclonus were significantly decreased in group BM （P〈0.05）.There was no significant difference in the incidence and severity of myoclonus between group B and group M （P 〉 0.05）.Conclusion Butorphanol or midazolam alone produces similar efficacy in preventing etomidate-induced myoclonus during anesthesia induction, and the combination of the two drugs provides better efficacy than either alone in the patients.

关 键 词：布托啡诺 咪达唑仑 依托咪酯 肌阵挛 

分 类 号：R614[医药卫生—麻醉学]