依托咪酯与丙泊酚混合液在小儿全身麻醉诱导中的临床研究  

Linical Evaluation of Etomidate and Propofolmixture for Induction of General Anaesthesia in Children

作　　者：刘景 任会杰 黄海萍 汪飞[2] 高晓枫[2] LIU Jing;REN Hui-Jie;HUANG Hai-Ping;WANG Fei;GAO Xiao-Feng(Huizhou First People's Hospital,Huizhou Guangdong 516000,China)

机构地区：[1]惠州市第一人民医院药学部,广东惠州516000 [2]惠州市第一人民医院麻醉科,广东惠州516000 [3]惠州市第一人民医院介入导管室,广东惠州516000

出　　处：《药品评价》2020年第9期48-51,共4页Drug Evaluation

基　　金：广东省惠州市科技局基金项目(编号2019Y076)。

摘　　要：目的:探讨依托咪酯和丙泊酚混合液与依托咪酯及丙泊酚在小儿全身麻醉诱导中的应用效果。方法:选择4~7岁患儿择期全身麻醉手术90例,随机分为依托咪酯和丙泊酚混合液组(EP组,体积比1:1)、依托咪酯组(E组)和丙泊酚组(P组),每组30例,给予咪达唑仑0.1mg/kg,患儿入睡后进入手术间。麻醉诱导采用双盲随机对照方法,EP、E和P组静脉均给予0.2mL/kg,顺次给予舒芬太尼0.5μg/kg,苯磺酸顺阿曲库铵0.2mg/kg,给药3分后行气管内插管。记录患儿入室后麻醉诱导前(T0)、麻醉诱导后插管前(T1)、插管时即刻(T2)、插管后1min(T3)、3min(T4)和5min(T5)患儿的平均动脉压(MAP)和心率(HR);比较三组患儿注射痛、肌颤和躁动等不良反应的差异。结果:三组患儿T0时刻平均血压和心率比较,P>0.05,T1时刻EP和E组血压比较P<0.05,心率比较P>0.05,三组患儿T2、T3、T4和T5时刻平均血压和心率比较,P<0.05。三组患儿注射痛比较EP和E组注射痛比较P>0.05,EP和E组与P组注射痛比较P<0.05,三组患儿肌颤和躁动比较P<0.05。结论:EP组患儿心率和血压相对平稳,波动小,更为理想,肌颤和躁动发生率比较EP组为最优,EP和E组注射痛比较差异无统计学意义。依托咪酯和丙泊酚混合液可以很好地应用于临床小儿全身麻醉的诱导。Objective:Our aim was to evaluate induction of general anaesthesia in children with an etomidate and propofol(Vol:Vol=1:1)mixture and to compare the outcomes to those achieved etomidate or propofol alone.Methods:Ninety patients between 4-7 years of age,who were undergoing surgical procedures under general anaesthesia,were selected to participate in a randomised,double-blinded,controlled study.The patients were divided into three groups including group EP,anaesthesia induced with mixed etomidate and propofol;group E,anaesthesia induced with etomidate alone and group P,anaesthesia induced with propofol alone.All patients were sedated with midazolam(0.1mg/kg)and were asleep prior to entering the surgical suite.Test substances were administered at 0.2mL/kg via the intravenous route followed by sufentanil(0.5μg/kg)and cisatracuriumbesylate(0.2mg/kg).Endotracheal intubation was performed three minutes after induction.Mean arterial pressure(MAP)and heart rate(HR)were recorded before induction(T0),before intubation(T1),immediately after intubation(T2),and 1,3 and 5 minutes after intubation(T3,T4 and T5,respectively).The frequency of adverse reactions including injection pain,myokymia and agitation was compared among the three groups.Results:No significant differences in MAP or HR were detected at T0(P>0.05).Significant differences in MAP(P<0.05)although not HR(P>0.05)were detected at T1 in a comparison of those in group EP to those in group E.By contrast,we observed significant differences(P<0.05)in both MAP and HR at T2–T5 inclusive.Among these findings,significant differences in injection pain in groups EP and E vs.group P(P<0.05),although there were no significant differences between group EP and group E(P<0.05).Similarly,we observed differences in myokymia and agitationamong the three groups(P<0.05).Conclusion:HR and MAP were relatively stable among children in group EP.Children in group EP also presented with the lowest incidence of myokymia and agitation during the study period and there were no significant diff

关 键 词：依托咪酯 丙泊酚 肌颤 注射痛 小儿 全身麻醉 

分 类 号：R971[医药卫生—药品]