CAJ | 학술논문

目的：探讨依托咪酯-丙泊酚混合液在无抽搐电休克( MECT)麻醉中的应用价值。方法：150例行MECT治疗患者随机分成3组,分别应用依托咪酯-丙泊酚混合液(E-P组)、依托咪酯(E组)、丙泊酚(P组)麻醉,记录麻醉前(T0)、麻醉后意识消失时(T1)、治疗即刻(T2)、治疗后1min(T3)、3min(T4)、5min(T5)的HR、SBP、DBP,计算HR与SBP的乘积(RPP)；记录麻醉过程中患者出现的注射疼、恶心呕吐、分泌物过多不良反应。结果：T1时3组SBP、DBP明显低于T0时,HR、RPP 明显高于T0时；T2~T5时P组 SBP、DBP、HR、RPP 明显低于E-P、E两组,且E组HR、RPP高于E-P组,T2~T3时SBP、DBP、HR、RPP明显高于T0时,T4时E、E-P组SBP、DBP、HR、RPP明显高于T0时,P组DBP、HR、明显高于T0时,RPP明显低于T0时；T5时E组HR、RPP明显高于,E-P、P组SBP、DBP、HR、RPP明显低于T0时,比较均有统计学意义(P<0.05)；注射疼P组明显高于E-P、E组(P<0.05),分泌物过多E组明显高于E-P、P组(P<0.05),恶心呕吐3组患者无差别。结论：依托咪酯-丙泊酚混合液应用于MECT麻醉优于两种药物的单独应用。
목적：탐토의탁미지-병박분혼합액재무추휵전휴극( MECT)마취중적응용개치。방법：150례행MECT치료환자수궤분성3조,분별응용의탁미지-병박분혼합액(E-P조)、의탁미지(E조)、병박분(P조)마취,기록마취전(T0)、마취후의식소실시(T1)、치료즉각(T2)、치료후1min(T3)、3min(T4)、5min(T5)적HR、SBP、DBP,계산HR여SBP적승적(RPP)；기록마취과정중환자출현적주사동、악심구토、분비물과다불량반응。결과：T1시3조SBP、DBP명현저우T0시,HR、RPP 명현고우T0시；T2~T5시P조 SBP、DBP、HR、RPP 명현저우E-P、E량조,차E조HR、RPP고우E-P조,T2~T3시SBP、DBP、HR、RPP명현고우T0시,T4시E、E-P조SBP、DBP、HR、RPP명현고우T0시,P조DBP、HR、명현고우T0시,RPP명현저우T0시；T5시E조HR、RPP명현고우,E-P、P조SBP、DBP、HR、RPP명현저우T0시,비교균유통계학의의(P<0.05)；주사동P조명현고우E-P、E조(P<0.05),분비물과다E조명현고우E-P、P조(P<0.05),악심구토3조환자무차별。결론：의탁미지-병박분혼합액응용우MECT마취우우량충약물적단독응용。
Objective:To explore the value of Etomidate + Propofol in anesthesia of modified electroconvulsive therapy ( MECT) . Methods:A total of 150 patients undergoing MECT were randomly assigned to three groups and anesthetized with Etomidate+ Propofol ( E-P group) , Etomidate ( E group) and Propofol ( P group) , respectively. Their heart rate ( HR) , systolic ( SBP) and diastolic blood pressure (DBP) were recorded before anesthesia (T0), at the loss of consciousness after anesthesia (T1), at instant treatment (T2) and at 1 (T3), 3 (T4) and 5 min (T5) after the treatment. The heart rate-pressure-product (RPP) were calculat-ed. The adverse reactions during anesthesia were recorded as injection pain, nausea/vomiting and excessive secretions. All data were processed with the SPSS V. 12. 0, and inspection standard of P<0. 05 had statistical significance. Results: SBP and DBP of the three groups at T1 were significantly lower than those at T0, while HR and RPP at T1 were significantly higher than those at T0. From T2 to T5, SBP, DBP, HR and RPP of P group were significantly lower than those of E-P and E groups, and HR and RPP of E group were higher than those of E-P. SBP, DBP, HR and RPP at T2 and T3 were significantly higher than those at T0. At T4, SBP, DBP, HR, and RPP of E and E-P groups were significantly higher than those at T0;DBP and HR of P group were significantly higher than those at T0, while RPP was significantly lower than that at T0. At T5, HR and RPP of E group were significantly higher than those at T0;SBP, DBP, HR and RPP of E-P and P groups were significantly lower than those at T0 (P<0. 05). Injection pain in P group was sig-nificantly higher than those in E-P and E groups (P<0. 05), so were excessive secretions in E group than E-P and P groups (P<0. 05). There were no significant differences in nausea/vomiting among the three groups. Conclusions:Etomidate+Propofol in the anes-thesia of MECT has an advantage over their single use.