不同用药方法预防依托咪酯诱导时肌阵挛的临床观察  

Clinical observation of different medication methods to prevent myoclonus induced by etomidate

作　　者：叶丽群[1] 何娟明 植碧清 梁静芳 YE Li-qun;HE Juan-ming;ZHI Bi-qing(Department of Anesthesiology,People’s Hospital of Huaiji County,Hechi 546400,China)

机构地区：[1]广东省怀集县人民医院麻醉科,546400

出　　处：《中国实用医药》2021年第14期136-139,共4页China Practical Medicine

基　　金：广东省肇庆市科技创新指导类项目(项目编号:202004030833)。

摘　　要：目的比较麻醉诱导时不同用药方法对预防依托咪酯肌阵挛的临床效果。方法90例择期行全身麻醉(全麻)气管插管手术患者,按照随机数字表法为A组、B组、C组,每组30例。A组和B组静脉泵注右美托咪定0.5μg/kg,A组静脉注射(静注)阿曲库铵,B组静注舒芬太尼,1 min后A组、B组和C组分别静脉给予依托咪酯。比较三组患者麻醉诱导时序贯预静注小剂量右美托咪定联合阿曲库铵或舒芬太尼后与依托咪酯静注完2 min内肌阵挛发生情况和预注前(T_(0))、预注中(T_(1))、预注后(T_(2))不同时点收缩压(SBP)、心率(HR)、血氧饱和度(SpO_(2))水平。结果C组肌阵挛发生率为53.3%,高于A组的6.7%和B组的13.3%,差异有统计学意义(P<0.05);A组和B组的肌阵挛发生率比较差异无统计学意义(P>0.05)。T_(0)、T_(1)、T_(2)时,三组患者SBP、HR、SPO_(2)水平比较,差异均无统计学意义(P>0.05)。结论麻醉诱导时序贯预静注小剂量右美托咪定联合应用阿曲库铵或舒芬太尼,可明显降低依托咪酯诱发的肌阵挛发生率,且血流动力学较为稳定。Objective To compare the clinical effect of different medication methods to prevent myoclonus induced by etomidate. Methods A total of 90 patients undergoing elective general anesthesia(general anesthesia) for tracheal intubation were divided into group A, group B and group C according to random numerical table, with 30 cases in each group. Group A and group B were injected intravenously with dexmedetomidine 0.5μg/kg, group A was injected intravenously with atracurium besylate, group B was injected intravenously with sufentanil. 1 min later, group A, group B and group C were given etomidate intravenously. The occurrence of myoclonus, and systolic blood pressure(SBP), heart rate(HR) and blood oxygen saturation(SpO_(2)) before preinjection(T_(0)), pre-injection(T_(1)), after pre-injection(T_(2)) of the three groups were compared. Results The incidence of myoclonus of group C was 53.3%, which was higher than 6.7% of group A and 13.3% of group B, and the difference was statistically significant(P<0.05). There was no statistically significant difference in incidence of myoclonus between group A and group B(P>0.05). At T_(0), T_(1), T_(2), there was no statistically significant difference in levels of SBP, HR and SPO_(2) among three groups(P>0.05). Conclusion Low dose dexmedetomidine combined with atracurium or sufentanil during anesthesia induction can significantly reduce the incidence of myoclonus induced by etomidate, and the hemodynamics is relatively stable.

关 键 词：依托咪酯 肌阵挛 麻醉诱导 

分 类 号：R614[医药卫生—麻醉学]