中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
27期
30-32
,共3页
汪昊星%王志萍%王军%顾正峰
汪昊星%王誌萍%王軍%顧正峰
왕호성%왕지평%왕군%고정봉
右美托咪啶%依托咪酯%肌阵挛
右美託咪啶%依託咪酯%肌陣攣
우미탁미정%의탁미지%기진련
Dexmedetomidine%Etomidate%Myoclonus
目的 观察右美托咪定滴鼻对依托咪酯诱发肌阵挛的影响.方法 选择ASA分级Ⅰ～Ⅱ级的择期手术患者100例,按随机数字表法分为两组,每组50例,分别在麻醉诱导前用右美托咪定1μg/kg滴鼻(右美托咪定组)或等量0.9％氯化钠滴鼻(对照组),30 min后两组均静脉注射依托咪酯0.3 mg/kg,记录滴鼻前(T0)及滴鼻后15 min(T1)、30 min(T2)的平均动脉压(MAP)、心率、脉搏血氧饱和度(SpO2)和呼吸频率,观察肌阵挛发生情况并评级.结果 右美托咪定组T2时MAP、心率低于T0时[(75.9±8.1) mm Hg(1 mm Hg=0.133 kPa)比(81.4±10.4) mm Hg、(80.9±7.6)次/min比(85.9±9.1)次/min],差异有统计学意义(P＜0.05),但均在正常范围内；其他各时间点组内、组间比较差异均无统计学意义(P＞0.05).右美托咪定组肌阵挛发生率明显低于对照组[42％(21/50)比70％(35/50)],差异有统计学意义(P＜0.01).结论 右美托咪定滴鼻可安全有效地减少依托咪酯诱发的肌阵挛.
目的 觀察右美託咪定滴鼻對依託咪酯誘髮肌陣攣的影響.方法 選擇ASA分級Ⅰ～Ⅱ級的擇期手術患者100例,按隨機數字錶法分為兩組,每組50例,分彆在痳醉誘導前用右美託咪定1μg/kg滴鼻(右美託咪定組)或等量0.9％氯化鈉滴鼻(對照組),30 min後兩組均靜脈註射依託咪酯0.3 mg/kg,記錄滴鼻前(T0)及滴鼻後15 min(T1)、30 min(T2)的平均動脈壓(MAP)、心率、脈搏血氧飽和度(SpO2)和呼吸頻率,觀察肌陣攣髮生情況併評級.結果 右美託咪定組T2時MAP、心率低于T0時[(75.9±8.1) mm Hg(1 mm Hg=0.133 kPa)比(81.4±10.4) mm Hg、(80.9±7.6)次/min比(85.9±9.1)次/min],差異有統計學意義(P＜0.05),但均在正常範圍內；其他各時間點組內、組間比較差異均無統計學意義(P＞0.05).右美託咪定組肌陣攣髮生率明顯低于對照組[42％(21/50)比70％(35/50)],差異有統計學意義(P＜0.01).結論 右美託咪定滴鼻可安全有效地減少依託咪酯誘髮的肌陣攣.
목적 관찰우미탁미정적비대의탁미지유발기진련적영향.방법 선택ASA분급Ⅰ～Ⅱ급적택기수술환자100례,안수궤수자표법분위량조,매조50례,분별재마취유도전용우미탁미정1μg/kg적비(우미탁미정조)혹등량0.9％록화납적비(대조조),30 min후량조균정맥주사의탁미지0.3 mg/kg,기록적비전(T0)급적비후15 min(T1)、30 min(T2)적평균동맥압(MAP)、심솔、맥박혈양포화도(SpO2)화호흡빈솔,관찰기진련발생정황병평급.결과 우미탁미정조T2시MAP、심솔저우T0시[(75.9±8.1) mm Hg(1 mm Hg=0.133 kPa)비(81.4±10.4) mm Hg、(80.9±7.6)차/min비(85.9±9.1)차/min],차이유통계학의의(P＜0.05),단균재정상범위내；기타각시간점조내、조간비교차이균무통계학의의(P＞0.05).우미탁미정조기진련발생솔명현저우대조조[42％(21/50)비70％(35/50)],차이유통계학의의(P＜0.01).결론 우미탁미정적비가안전유효지감소의탁미지유발적기진련.
Objective To observe the effect of intranasal dexmedetomidine on preventing myoclonus induced by etomidate.Methods One hundred patients who ASA classification Ⅰ-Ⅱ grades were divided into two groups by random digits table method with 50 cases each.Before anesthesia induction with dexmedetomidine 1 μ g/kg (dexmedetomidine group) or equivalent 0.9％ sodium chloride (control group) intranasal,30 min after two groups were injected etomidate 0.3 mg/kg.Mean artery pressure(MAP),heart rate (HR),oxygen saturation with pulse oximetry (SpO2) and respiratary rate were recorded before intranasal instillation of dexmedetomidine (T0),at l5 min (T1) and 30 min (T2) after intranasal dexmedetomidine,myoclonus was observed and graded.Results The MAP,HR at T2 was lower than that at T0 in dexmedetomidine group [(75.9 ± 8.1) mm Hg (1 mm Hg =0.133 kPa) vs.(81.4 ± 10.4) mm Hg,(80.9 ± 7.6) times/min vs.(85.9 ± 9.1) times/min],there was significant difference (P ＜ 0.05),but all within the normal range; other within the group at each time point had no statistical significance between two groups (P ＞ 0.05).The incidence of myoclonus was significantly reduced in dexmedetomidine group compared with that in control group [42％(21/50) vs.70％(35/50)],there was significant difference (P ＜ 0.01).Conclusion Intranasal instillation of dexmedetomidine can safely prevent myoclonus induced by etomidate.
