老年患者全麻诱导预注小剂量丙泊酚对依托咪酯导致的肌阵挛的影响  

Influence of Low Dose Propofol Prejection on the Incidence of Etomidate Induced Myoclonus During General Anesthesia in Elderly Patients

作　　者：彭艳[1] 单希胜[1] 嵇富海[1] 钱菊[1] PENG Yan;SHAN Xi-sheng;JI Fu-hai;QIAN Ju(Department of Anesthesiology,First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China)

机构地区：[1]苏州大学附属第一医院麻醉科,江苏苏州215006

出　　处：《中国血液流变学杂志》2022年第2期193-196,221,共5页Chinese Journal of Hemorheology

基　　金：国家自然科学基金资助项目(8202130),江苏省自然科学基金资助项目(BK20191171),第十五批科技发展计划医疗器械与新医药(临床试验)项目(SLT201909)。

摘　　要：目的探讨全麻手术老年患者麻醉诱导期预先注射小剂量丙泊酚后对依托咪酯导致的肌阵挛的影响。方法2021年4月—8月苏州大学附属第一医院所收治的90例全麻老年手术患者作为观察对象,采用随机数字法将患者分配为预先注射丙泊酚组(P组)和未预先注射丙泊酚组(E组),均接受依托咪酯进行静脉诱导麻醉。监测并记录两组患者麻醉诱导期肌阵挛发生率和程度,同时比较患者在注射丙泊酚前(T1)和依托咪酯后(T2)血流动力学指标变化情况。结果P组患者肌阵挛发生率明显低于E组(22.2%vs 66.7%,P<0.05),此外P组中重度肌阵挛的发生率(11.1%)明显低于E组(44.4%),差异有统计学意义(P<0.05);P组患者注射依托咪酯收缩压轻度下降,与E组相比,差异无统计学意义(P>0.05)。结论全麻手术老年患者麻醉诱导期预注射小剂量丙泊酚(0.2 mg/kg)可减少依托咪酯导致肌阵挛的发生率并减轻其程度,同时保持血流动力学相对稳定。Objective To explore the preventive effect of pretreatment with low-dose Propofol on Etomidaterelated myoclonus during general anesthesia in elderly patients.Methods From April to August 2021,90 elderly patients were treated in the First Affiliated Hospital of Soochow University as observation objects.The patients were divided into pre-injected Propofol group(group P)and no pre-injected Propofol group(group E)by random number method,who received Etomidate for intravenous induction anesthesia.The incidence and degree of Etomidate induced myoclonus during anesthesia induction,and the changes of hemodynamic indexes before Propofol injection(T1)and after Etomidate injection(T2)were monitored and recorded in two groups.Results Myoclonic movements were significantly lower in group P than in group E(22.2%vs 66.7%,P<0.05).Additionally,the incidence of moderate to severe myoclonus in group P(11.1%)was significantly lower than that in group E(44.4%),the differences were statistically significant(P<0.05).The systolic blood pressure of patients injected with Etomidate in group P was slightly decreased,and there was no significant difference compared with group E(P>0.05).Conclusion Low-dose Propofol(0.2 mg/kg)with Etomidate before anesthesia induction can significantly reduce the incidence and intensity of myoclonus, maintain the stability of the elderly patient's intraoperative hemodynamic indicators.

关 键 词：依托咪酯 丙泊酚 肌阵挛 

分 类 号：R614.2[医药卫生—麻醉学]