曲马多预处理减少依托咪酯引起的肌阵挛的发生和严重程度  

Tramadol Pretreatment Reduces Myoclonus Induced by Etomidate

作　　者：付湘云[1] 刘志刚[1] 刘永芳[1] 胡刚[1] 谢恒涛 夏中元[1] 

机构地区：[1]武汉大学人民医院麻醉科

出　　处：《武汉大学学报（医学版）》2018年第2期287-290,共4页Medical Journal of Wuhan University

摘　　要：目的：分别观察1mg/kg及2mg/kg曲马多预处理对依托咪酯全麻诱导时引起的肌阵挛的预防作用。方法：90例择期全麻手术患者,随机均分为三组（T0、T1、T2,n=30）。全麻诱导前分别预注1 mg/kg曲马多（T1组）,2mg/kg曲马多（T2组）或同等剂量的生理盐水（T0组）,5min后静注0.3mg/kg依托咪酯并观察有无肌阵挛发生,同时记录肌阵挛的严重程度。间隔1min后予三组均静注0.6mg/kg罗库溴铵,5μg/kg芬太尼行气管插管并同时记录无创动脉血压（BP）和心率（HR）。结果：发生了肌阵挛的患者T0有的28例（93%,n=30）,T1组24例（80%,n=30）,T2组21例（70%,n=30）,预注曲马多的两组诱发肌阵挛的发生率明显低于对照组（P〈0.01）。T2组副反应的发生率明显高于T1组和T0组（P〈0.05）。结论：曲马多预处理可减少依托咪酯全麻诱导所致的肌阵挛,且剂量为1mg/kg的曲马多预注效果更佳。Objective： To investigate the effect of pretreatment with tramadol on the occurrence of eto- midate-induced myoclonus. Methods： Ninety adult ASA physical status Ⅰ-Ⅱ patients scheduled for elective surgery were included in the study. Patients were allocated to one of three groups randomly, double-blinded fashion via random number draws was received either a low dose of tra- madol （1mg/ kg; n=30; Group T1）, tramadol （2 mg/ kg; n=30; Group T2） or placebo （sa line; n=30; Group TO）. Five minutes after injection, anesthesia was induced with lipid formula- tion of etomidate （Etomidate-Lipuro） by 0.3 mg/kg over 30 s intravenously. One minute later, each patient was administered 0.6 mg/kg of rocuronium, and 5μg/kg of fentanyl to facilitate tra- cheal intubation. After intubation, anesthesia was maintained with the O2-air-sevoflurane mix- ture. Results： Frequency and severity of myoclonic movements were significantly lower in Groups T1 and T2 than that in Group T0（P〈0. 01）. The incidence of adverse effect of high dose of tramadol （Group T2） was higher than those of groups TO and TI（P〈0.05）. Conclusion： Pretreatment with low dose of tramadol is a good choice for preventing myoclonic movements during etomidate induction.

关 键 词：曲马多 依托咪酯 肌阵挛 

分 类 号：R746[医药卫生—神经病学与精神病学] R971[医药卫生—临床医学]