中国医药指南
中國醫藥指南
중국의약지남
CHINA MEDICINE GUIDE
2013年
22期
48-49,50
,共3页
李雄伟%昝京伟%张捷%刘国凯
李雄偉%昝京偉%張捷%劉國凱
리웅위%잠경위%장첩%류국개
地佐辛%依托咪酯%肌颤%全麻静脉诱导
地佐辛%依託咪酯%肌顫%全痳靜脈誘導
지좌신%의탁미지%기전%전마정맥유도
Dezocine%Etomidate%Muscle fibrillation%Vein general anesthesia induction
目的观察地佐辛复合依托咪酯用于全麻插管患者在诱导时减轻依托咪酯肌颤副作用的临床效果；方法将90例全麻插管患者随机分为D组（地佐辛）、F组（芬太尼）及N组（氯化钠），均采用气管插管全凭静脉麻醉，依托咪酯诱导，术中靶控输注异丙酚、瑞芬太尼，间断给予维库溴铵维持麻醉，诱导前10min分别静注：实验组1为地佐辛0.1mg/kg，实验组2组为芬太尼1μg/kg，对照组为氯化钠5mL，记录各组患者在全麻诱导过程中肌颤发生例数及给药时（T0）、插管时（T1）插管后5min（T2）患者血流的动力学指标（HR、SBP、DBP）和SpO2及BIS值。结果 D组（地佐辛）的肌颤发生例数明显低于F组(芬太尼)及N组（氯化钠）（P<0.05），心率、血压及BIS值的变化在T1明显低于F组及N组(P<0.05)，F组与N组间无显著性差异，SpO2在T0、T1、T2时间点无显著性差异。结论地佐辛诱导前静注对减轻依托咪酯的肌颤副作用和维持血流动力学平稳方面有显著作用，是一种值得推广的诱导方法。
目的觀察地佐辛複閤依託咪酯用于全痳插管患者在誘導時減輕依託咪酯肌顫副作用的臨床效果；方法將90例全痳插管患者隨機分為D組（地佐辛）、F組（芬太尼）及N組（氯化鈉），均採用氣管插管全憑靜脈痳醉，依託咪酯誘導，術中靶控輸註異丙酚、瑞芬太尼，間斷給予維庫溴銨維持痳醉，誘導前10min分彆靜註：實驗組1為地佐辛0.1mg/kg，實驗組2組為芬太尼1μg/kg，對照組為氯化鈉5mL，記錄各組患者在全痳誘導過程中肌顫髮生例數及給藥時（T0）、插管時（T1）插管後5min（T2）患者血流的動力學指標（HR、SBP、DBP）和SpO2及BIS值。結果 D組（地佐辛）的肌顫髮生例數明顯低于F組(芬太尼)及N組（氯化鈉）（P<0.05），心率、血壓及BIS值的變化在T1明顯低于F組及N組(P<0.05)，F組與N組間無顯著性差異，SpO2在T0、T1、T2時間點無顯著性差異。結論地佐辛誘導前靜註對減輕依託咪酯的肌顫副作用和維持血流動力學平穩方麵有顯著作用，是一種值得推廣的誘導方法。
목적관찰지좌신복합의탁미지용우전마삽관환자재유도시감경의탁미지기전부작용적림상효과；방법장90례전마삽관환자수궤분위D조（지좌신）、F조（분태니）급N조（록화납），균채용기관삽관전빙정맥마취，의탁미지유도，술중파공수주이병분、서분태니，간단급여유고추안유지마취，유도전10min분별정주：실험조1위지좌신0.1mg/kg，실험조2조위분태니1μg/kg，대조조위록화납5mL，기록각조환자재전마유도과정중기전발생례수급급약시（T0）、삽관시（T1）삽관후5min（T2）환자혈류적동역학지표（HR、SBP、DBP）화SpO2급BIS치。결과 D조（지좌신）적기전발생례수명현저우F조(분태니)급N조（록화납）（P<0.05），심솔、혈압급BIS치적변화재T1명현저우F조급N조(P<0.05)，F조여N조간무현저성차이，SpO2재T0、T1、T2시간점무현저성차이。결론지좌신유도전정주대감경의탁미지적기전부작용화유지혈류동역학평은방면유현저작용，시일충치득추엄적유도방법。
Objective Observe the adjuvant effect of compound of etomidate for intubation in patients during induction of anesthesia to alleviate side effects of etomidate muscle fibrillation clinical effect. Methods 90 patients with General anesthesia intubation randomly divided into group D(Dezocine), Group F (fentanyl) and Group N(NCcl) would be adopted in total intravenous anesthesia by tracheal intubation, etomidate and remifentanil during target-controlled infusion , interruption infusion of Vecuronium in the maintenance of anaesthesia. Induced respectively 10 minutes before infusion:Dezocine 0.1mg/kg experimental group, group F for fentanyl, 1μg/kg, and Group N for NaCl 5mL, record group during induction of anesthesia in patients with muscle fibrillation frequency and delivery time (T0), intubation (T1) 5 minutes after intubation (T2) blood flow dynamics in patients with indicators (HR, and SBP, and DBP) and SpO2. Results Group D(Dezocine), significantly lower than the number of muscle fibrillation F(fentanyl) and N(nacl)(P<0.05), changes in heart rate and blood pressure in T1 clearly lower than group F (P<0.05), SpO2 in T0, T1, T2 time points, no significant difference. Conclusion Dezocine before induction injection on alleviating side effects of Etomidate muscle fibrillation and maintenance of hemodynamics in a smooth, have a significant role, is a kind of induction methods worthy of promotion.
