右美托咪定减轻依托咪酯诱导诱发肌阵挛的效果  

Efficacy of dexmedetomidine in reducing etomidate-induced myoclonus

作　　者：陈祖萍[1] 程崇学[1] 李大佳[1] 袁岩[1] 沈江[1] 

机构地区：[1]常州市第一人民医院麻醉科,江苏省213003

出　　处：《江苏医药》2016年第21期2335-2337,共3页Jiangsu Medical Journal

摘　　要：目的探讨右美托咪定对老年患者全身麻醉诱导期依托咪酯诱发肌阵挛的影响。方法 90例全身麻醉老年患者随机均分为三组,在麻醉诱导前10min内分别静脉泵注右美托咪定0.2μg/kg(A组)、0.4μg/kg(B组)及生理盐水(C组)。随后,三组静脉注射依托咪酯0.2mg/kg,观察依托咪酯注射后1min内肌阵挛发生情况,并评估其严重程度。记录用药期间的血压和心率变化。结果 A组和B组肌阵挛发生率均低于C组(13.3%和10.0%vs.46.7%)(P<0.01)。右美托咪定泵注期间均未发生严重低血压。B组心动过缓发生率为16.7%,高于A组的6.7%(P<0.05),C组未见心动过缓发生。结论预注右美托咪定0.2μg/kg或0.4μg/kg均可有效降低老年患者全身麻醉诱导期依托咪酯诱发的肌阵挛发生率,但0.2μg/kg对心率影响较小。Objective To evaluate the effect of dexmedetomidine in reducing etomidate-induced myoclonus in elderly patients during general anesthesia introduction period. Methods Ninety elderly patients undergoing general anesthesia were equally randomly into three groups. The patients in groups of A and B were in intravenous infused dexmedetomidine 0. 2μg/kg and 0. 4 μg/kg within 10 minutes before anesthesia induction. The patients in group C were given normal saline as the controls. Etomidate 0. 2 mg/kg was intravenous infused into three groups. The incidence and severity of myoclonus were recorded in one minute after etornidate administration. The changes of BP and HR were monitored as well. Results The incidence rate of myoclonus was lower in groups of A and B than that in group C（13. 3% and 10.0% vs. 46.7%） （P〈0. 01）. There was no severe hypotension during dexmedetomidine infusion in groups of A and B. The incidence rate of bradycardia in group B was 16.7% ,which was higher than 6.7% in group A（P〈0. 05）. There was no case with bradycardia in group C. Conclusion The pretreatment with dexmedetomidine 0. 2 μg/kg or 0.4 μg/kg can effectively reduce the incidence rate of etomidate-induced myoclonus. The former dose has less effect on HR.

关 键 词：右美托咪定 依托咪酯 肌阵挛 老年 

分 类 号：R614[医药卫生—麻醉学]