临床麻醉学杂志
臨床痳醉學雜誌
림상마취학잡지
THE JOURNAL OF CLINICAL ANESTHESIOLOGY
2010年
2期
129-131
,共3页
廖朝辉%幸标%沈娴文%王灿琴%钱燕宁%王忠云
廖朝輝%倖標%瀋嫻文%王燦琴%錢燕寧%王忠雲
료조휘%행표%침한문%왕찬금%전연저%왕충운
依托咪酯%咪唑安定%芬太尼%肌阵挛
依託咪酯%咪唑安定%芬太尼%肌陣攣
의탁미지%미서안정%분태니%기진련
Etomidate%Midazolam%Fentanyl%Myoclonus
目的 研究咪唑安定和芬太尼对依托咪酯所致肌阵挛的影响.方法 全麻下行择期手术患者128例,根据麻醉诱导用药顺序和剂量的不同随机分为五组:Ⅰ组,咪唑安定0.05 mg/kg、依托咪酯0.25 mg/kg、芬太尼3μg/kg,22例;Ⅱ组,芬太尼3 μg/kg、依托咪酯0.25 mg/kg、咪唑安定0.05 mg/kg,24例;Ⅲ组,咪唑安定0.05 mg/kg、芬太尼3 μg/kg、依托咪酯0.25 mg/kg,32例;Ⅳ组,咪唑安定0.08 mg/kg、依托咪酯0.25 mg/kg、芬太尼3 μg/kg,23例;Ⅴ组(对照组),依托咪酯0.25 mg/kg、咪唑安定0.05 mg/kg、芬太尼3 μg/kg,27例.在静注依托咪酯后,观察并记录2 min内肌阵挛阳性率及发生分级.结果 五组肌阵挛阳性率分别为68.18%、41.67%、21.88%、21.74%、59.26%.与Ⅴ组比,Ⅲ、Ⅳ组肌阵挛阳性率及发生分级明显较低(P<0.05),Ⅰ、Ⅱ组肌阵挛阳性率及发生分级差异则无统计学意义.结论 依次采用咪唑安定、芬太尼、依托咪酯诱导可减低依托咪酯引起的肌阵挛发生.
目的 研究咪唑安定和芬太尼對依託咪酯所緻肌陣攣的影響.方法 全痳下行擇期手術患者128例,根據痳醉誘導用藥順序和劑量的不同隨機分為五組:Ⅰ組,咪唑安定0.05 mg/kg、依託咪酯0.25 mg/kg、芬太尼3μg/kg,22例;Ⅱ組,芬太尼3 μg/kg、依託咪酯0.25 mg/kg、咪唑安定0.05 mg/kg,24例;Ⅲ組,咪唑安定0.05 mg/kg、芬太尼3 μg/kg、依託咪酯0.25 mg/kg,32例;Ⅳ組,咪唑安定0.08 mg/kg、依託咪酯0.25 mg/kg、芬太尼3 μg/kg,23例;Ⅴ組(對照組),依託咪酯0.25 mg/kg、咪唑安定0.05 mg/kg、芬太尼3 μg/kg,27例.在靜註依託咪酯後,觀察併記錄2 min內肌陣攣暘性率及髮生分級.結果 五組肌陣攣暘性率分彆為68.18%、41.67%、21.88%、21.74%、59.26%.與Ⅴ組比,Ⅲ、Ⅳ組肌陣攣暘性率及髮生分級明顯較低(P<0.05),Ⅰ、Ⅱ組肌陣攣暘性率及髮生分級差異則無統計學意義.結論 依次採用咪唑安定、芬太尼、依託咪酯誘導可減低依託咪酯引起的肌陣攣髮生.
목적 연구미서안정화분태니대의탁미지소치기진련적영향.방법 전마하행택기수술환자128례,근거마취유도용약순서화제량적불동수궤분위오조:Ⅰ조,미서안정0.05 mg/kg、의탁미지0.25 mg/kg、분태니3μg/kg,22례;Ⅱ조,분태니3 μg/kg、의탁미지0.25 mg/kg、미서안정0.05 mg/kg,24례;Ⅲ조,미서안정0.05 mg/kg、분태니3 μg/kg、의탁미지0.25 mg/kg,32례;Ⅳ조,미서안정0.08 mg/kg、의탁미지0.25 mg/kg、분태니3 μg/kg,23례;Ⅴ조(대조조),의탁미지0.25 mg/kg、미서안정0.05 mg/kg、분태니3 μg/kg,27례.재정주의탁미지후,관찰병기록2 min내기진련양성솔급발생분급.결과 오조기진련양성솔분별위68.18%、41.67%、21.88%、21.74%、59.26%.여Ⅴ조비,Ⅲ、Ⅳ조기진련양성솔급발생분급명현교저(P<0.05),Ⅰ、Ⅱ조기진련양성솔급발생분급차이칙무통계학의의.결론 의차채용미서안정、분태니、의탁미지유도가감저의탁미지인기적기진련발생.
Objective To investigate the effect of midazolam and fentanyl on etomidate-induced myoclonus. Methods A total of 128 patients scheduled for surgery under genaral anesthesia were randomly divided into 5 groups according to the different sequence and dose of anesthetics during anesthesia induction. Midazolam 0. 05 mg/kg, etomidate 0. 25 mg/kg and fentanyl 3μg/kg was used in group Ⅰ, fentanyl 3 μg/kg, etomidate 0. 25 mg/kg, midazolam 0.05 rng/kg in group H,midazoIam 0. 05 mg/kg, fentanyl 3 μg/kg, etomidate 0. 25 mg/kg in group Ⅲ, midazolam 0. 08 mg/kg, etomidate 0. 25 mg/kg, fentanyl 3 μg/kg in group Ⅳ, etomidate 0. 25 mg/kg, midazolam 0. 05 mg/kg, fentanyl 3 μg/kg in group Ⅴ as the control After the injection of etomidate, the scales and positive incidences of myoclonus were observed within 2 minutes. Results The positive incidences of myoclonus were 68. 18% in group Ⅰ, 41.67% in group Ⅱ, 21.88% in group Ⅲ, 21.74% in group Ⅳ, and 59. 26% in group Ⅴ, respectively. Compared with group Ⅴ, groups of Ⅲ and Ⅳ had lower positive incidences and scales (P < 0. 05), whereas groups of Ⅰ and Ⅱ had no statistical changes in positive incidences and scales. Conclusion Using midazolarn, fentanyl, and etomidate consequently may reduce the occurrence of etornidate-induced myoclonus during anesthesia induction.
