不同剂量右美托咪定预处理对依托咪酯诱发肌颤的影响  

Effects of different doses of dexmedetomidine pretreatment on etomidate induced myofibrillation

作　　者：朱云霞[1] 尤杰[1] 孙大鹏[1] 季永[1] ZHU Yunxia;YOU Jie;SUN Dapeng;JI Yong(Anesthesiology Department,Affiliated Hospital of Jiangnan University,Wuxi 214000,China)

机构地区：[1]江南大学附属医院麻醉科,江苏无锡214000

出　　处：《临床医学研究与实践》2022年第17期125-127,共3页Clinical Research and Practice

摘　　要：目的探究不同剂量右美托咪定预处理对依托咪酯诱发肌颤的影响。方法选择我院2020年6月至12月需行全身麻醉的120例择期手术患者为研究对象,采用随机数字表法将其分为四组,即C组(生理盐水)、D_(0.2)组(右美托咪定0.2μg/kg)、D_(0.4)组(右美托咪定0.4μg/kg)、D_(0.8)组(右美托咪定0.8μg/kg),各30例。经前臂外周静脉给予生理盐水或不同剂量右美托咪定预处理,时间>10 min,后予以依托咪酯0.3 mg/kg静脉推注。观察并记录依托咪酯推注后2 min内患者的肌颤发生情况及严重程度;观察并记录右美托咪定开始输注至依托咪酯推注后2 min内患者发生严重窦性心动过缓的情况。结果C组、D_(0.2)组、D_(0.4)组及D_(0.8)组患者的肌颤总发生率分别为73.33%、53.33%、26.67%及13.33%。D_(0.2)组、D_(0.4)组及D_(0.8)组的肌颤总发生率均显著低于C组,差异具有统计学意义(P<0.05);D_(0.4)组及D_(0.8)组的肌颤总发生率均显著低于D_(0.2)组,差异具有统计学意义(P<0.05);D_(0.8)组、D_(0.4)组的肌颤总发生率比较,差异无统计学意义(P>0.05)。Spearman相关性分析结果显示,不同剂量右美托咪定预处理与依托咪酯诱发肌颤具有相关性(r=-0.514,P=0.00)。D_(0.8)组的严重窦性心动过缓发生率高于D_(0.4)组,差异具有统计学意义(P<0.05)。结论0.4或0.8μg/kg的右美托咪定预处理可显著降低依托咪酯诱发肌颤的发生率,而0.4μg/kg严重窦性心动过缓的发生率更低。Objective To explore the effects of different doses of dexmedetomidine pretreatment on etomidate induced myofibrillation.Methods A total of 120 patients undergoing elective surgery requiring general anesthesia in our hospital from June to December 2020 were selected as the research objects and divided into four groups by random number table method,namely group C(normal saline),group D_(0.2)(dexmedetomidine 0.2μg/kg),group D_(0.4)(dexmedetomidine 0.4μg/kg),group D_(0.8)(dexmedetomidine 0.8μg/kg),with 30 cases in each group.After pretreatment with normal saline or different doses of dexmedetomidine through the peripheral vein of forearm for more than 10 min,etomidate 0.3 mg/kg was intravenously injected.The occurrence and severity of myofibrillation were observed and recorded within 2 min after etomidate injection;the occurrence of severe sinus bradycardia was observed and recorded from the beginning of dexmedetomidine infusion to 2 min after etomidate injection.Results The total incidence rates of myofibrillation in the group C,D_(0.2),D_(0.4) and D_(0.8) were 73.33%,53.33%,26.67%and 13.33%,respectively.The total incidence of muscle fibrillation in the group D_(0.2),D_(0.4) and D_(0.8 )was significantly lower than that in the group C,and the difference was statistically significant(P<0.05);the total incidence of myofibrillation in the group D_(0.4) and D_(0.8) was significantly lower than that in the group D_(0.2),and the difference was statistically significant(P<0.05);there was no significant difference in the total incidence of muscle fibrillation between the group D_(0.8) and D_(0.4)(P>0.05).Spearman correlation analysis result showed that different doses of dexmedetomidine pretreatment were correlated with etomidate induced fibrillation(r=-0.514,P=0.00).The incidence of severe sinus bradycardia in the group D_(0.8) was higher than that in the group D_(0.4),and the difference was statistically significant(P<0.05).Conclusion Dexmedetomidine pretreatment of 0.4 or 0.8μg/kg can significantly reduce the incide

关 键 词：右美托咪定 依托咪酯 肌颤 心动过缓 

分 类 号：R614[医药卫生—麻醉学]