CAJ | 학술논문

目的：观察右美托咪定术前滴鼻预处理对预防全身麻醉诱导期依托咪酯注射痛及肌阵挛的影响。方法：60例择期全麻手术者随机分为右美托咪定组（D 组）和对照组（N 组），各30例。D 组术前30 min 鼻内滴入右美托咪定（1.0μg·kg -1）；N 组术前30 min 鼻内滴入同等剂量0.9%氯化钠溶液。麻醉诱导时每组均静注依托咪酯0.3 mg·kg -1。记录两组预给药前（T0）、给依托咪酯前（T1）及给依托咪酯后1 min（T2）、2 min（T3）的血压（BP）、心率（HR）、血氧饱合度（SPO2）；采用词语等级评分法（VRS）评估依托咪酯注射痛；观察并记录静注依托咪酯后2 min 内肌阵挛发生情况。结果：与 T0比较，D 组 HR、MAP 在 T1、T2、T3明显降低（均<0.05），N 组 T2、T3明显降低（均<0.05）；D 组 HR 在 T1、T2、T3较 N 组降低（均<0.05）。D 组 MAP、SPO2在 T1、T2、T3时点较N 组稍降低（均>0.05）；D 组肌阵挛各级发生率均较 N 组降低（均<0.05）；与 N 组比较，D 组依托咪酯注射痛的发生率和严重程度均明显降低（<0.05）。结论：右美托咪定术前鼻内滴注，能有效减轻麻醉诱导期依托咪酯注射痛，还可减少依托咪酯诱导所致肌阵挛的发生，提供更稳定的血流动力环境。
목적：관찰우미탁미정술전적비예처리대예방전신마취유도기의탁미지주사통급기진련적영향。방법：60례택기전마수술자수궤분위우미탁미정조（D 조）화대조조（N 조），각30례。D 조술전30 min 비내적입우미탁미정（1.0μg·kg -1）；N 조술전30 min 비내적입동등제량0.9%록화납용액。마취유도시매조균정주의탁미지0.3 mg·kg -1。기록량조예급약전（T0）、급의탁미지전（T1）급급의탁미지후1 min（T2）、2 min（T3）적혈압（BP）、심솔（HR）、혈양포합도（SPO2）；채용사어등급평분법（VRS）평고의탁미지주사통；관찰병기록정주의탁미지후2 min 내기진련발생정황。결과：여 T0비교，D 조 HR、MAP 재 T1、T2、T3명현강저（균<0.05），N 조 T2、T3명현강저（균<0.05）；D 조 HR 재 T1、T2、T3교 N 조강저（균<0.05）。D 조 MAP、SPO2재 T1、T2、T3시점교N 조초강저（균>0.05）；D 조기진련각급발생솔균교 N 조강저（균<0.05）；여 N 조비교，D 조의탁미지주사통적발생솔화엄중정도균명현강저（<0.05）。결론：우미탁미정술전비내적주，능유효감경마취유도기의탁미지주사통，환가감소의탁미지유도소치기진련적발생，제공경은정적혈류동력배경。
Objectiye:To investigate the effects of etomidate injection pain and myoclonus given intranasal dexmedetomi-dine premedication on the induction of gereral anesthesia. Methods:Sixty cases undergone operation were randomly allo-cated to each group. Intranasal administrated dexmedetomidine1. 0 μg·kg - 1(group D n = 30)or given same volume of saline( group N n = 30)30 min before surgery. Blood pressure(BP),heart rate(HR),oxygen saturation(SPO2 )were recorded before drug(T0 ),to etomidate before(T1 )and to 1 min(T2 )、2 min(T3 )after etomidate. Scoring method used words(VRS)for etomidate injection pain score;observed and recorded myoclonus occurrence within 2 min after in-travenous etomidate. Results:There were no differences between two groups in all indexes before drug( > 0. 05). The SBP,HR,the VRS scores and myoclonus occurrence of group D were significantly lower than that of group N after drug(< 0. 05). SPO2 had no statistical significance between the two groups before and after drug( > 0. 05). Conclusions:These results suggest that the intranasal administration of dexmedetomidine in patients before operation is a safe and effec-tive preoperation medication,Not only can effectively reduce etomidate injection pain,but also significantly reduce myoc-lonus occurrence induced by etomidate to provide a more stable hemodynamic conditions.