两种剂量依托咪酯对神经监护气管插管条件的影响  

Effects of Two Doses of Etomidate on Endotracheal Intubation Conditions in Nerve Monitoring

作　　者：蓝建宁 LAN Jianning(Department of Anesthesiology,Union Hospital Affiliated to Fujian Medical University,Fuzhou,Fujian Province,350001 China)

机构地区：[1]福建医科大学附属协和医院麻醉科,福建福州350001

出　　处：《中外医疗》2022年第35期124-127,共4页China & Foreign Medical Treatment

摘　　要：目的 分析1倍ED_(95)顺式阿曲库铵辅助下不同剂量依托咪酯对神经监护气管插管条件的影响。方法 回顾性选取2021年2—6月期间在福建医科大学附属协和医院同一治疗组择期行术中喉返神经监测甲状腺切除术的患者100例,根据麻醉诱导时依托咪酯剂量分为P1组(0.25 mg/kg)50例和P2组(0.3 mg/kg)50例。对比两组患者各时间点心率(HR)、收缩压(SBP)、舒张压(DBP)、神经监护气管插管条件。结果 100例患者均达到一次性成功插管标准。P2组插管条件分级为4级(33例)的例数明显多于P1组(15例),差异有统计学意义(Z=-3.731,P<0.05)。两组各时间点血流动力学指标比较,差异无统计学意义(P>0.05)。结论 在1倍ED95顺式阿曲库铵辅助下,单次静注依托咪酯0.3 mg/kg可为气管插管提供临床满意的神经监护条件,不会对术后的喉返神经监测工作造成影响,也不会使低血压发生风险升高。Objective To analyze the effects of different doses of etomidate on endotracheal intubation conditions of nerve monitoring with the aid of 1 ED95 cis-atracurium.Methods From February to June 2021,100 patients in the same treatment group of the Union Medical College Hospital affiliated to Fujian Medical University who underwent intraoperative recurrent laryngeal nerve monitoring thyroidectomy were retrospective selected.According to the dose of etomidate during anesthesia induction,fifty cases were divided into P1 group(0.25 mg/kg)and P2 group(0.3 mg/kg).The heart rate(HR),systolic pressure(SBP),diastolic pressure(DBP),and endotracheal intubation conditions of nerve monitoring were compared between the two groups.Results All the one hundred patients achieved one-time successful intubation standards.In group P2,the number of cases classified as level 4(33 cases)was higher than that in group P1(15 cases),and the difference was statistically significant(Z=-3.731,P<0.05).There was no statistically significant difference in hemodynamic indexes at each time point in between the two groups(P>0.05).Conclusion A single infusion of 0.3 mg/kg etomidate,assisted by ED95 cisatracurium,can provide clinically satisfactory nerve monitoring conditions for endotracheal intubation,and will not affect postoperative laryngeal nerve monitoring or increase the risk of hypotension.

关 键 词：依托咪酯 术中神经监测 气管插管 喉返神经 甲状腺切除 

分 类 号：R4[医药卫生—临床医学]