实用药物与临床
實用藥物與臨床
실용약물여림상
PRACTICAL PHARMACY AND CLINICAL REMEDIES
2014年
10期
1266-1268,1269
,共4页
依托咪酯%肌阵挛%全麻诱导%妇科手术
依託咪酯%肌陣攣%全痳誘導%婦科手術
의탁미지%기진련%전마유도%부과수술
Etomidate%Myoclonus%General anesthesia induction%Gynecological surgery
目的：研究依托咪酯不同输注速度对全麻患者肌阵挛的影响。方法选取妇科全麻手术的患者90例,平均分成3组,每组30例,记录患者的入室平均动脉压( MAP)、心率( HR)。开通静脉后,在诱导期以不同的速度静脉输注总量为0．3 mg/kg的依托咪酯。输注速度：A组0．9 mg/(kg·min),B组0．45 mg/(kg·min),C组0．23 mg/( kg·min)。患者入睡后,记录肌阵挛的发生情况,然后给予0．1 mg芬太尼,0．15 mg/kg顺苯,并吸入6%七氟醚,2 min后给予插管。记录输注依托咪酯结束后1、5、8 min的MAP、HR。结果 B组肌阵挛的发生率低于A组,但B组与C组比较差异无统计学意义,其中B组发生肌阵挛的程度以1、2级为主,而A组和C组均以2、3级为主。给药后5 min,三组患者MAP升高,给药后8 min有所下降。三组心率比较差异无统计学意义。结论依托咪酯以一定的速度推注,可以减少肌阵挛的发生率并减轻其发生程度,本实验的最适速度是0．45 mg/( kg·min)。
目的：研究依託咪酯不同輸註速度對全痳患者肌陣攣的影響。方法選取婦科全痳手術的患者90例,平均分成3組,每組30例,記錄患者的入室平均動脈壓( MAP)、心率( HR)。開通靜脈後,在誘導期以不同的速度靜脈輸註總量為0．3 mg/kg的依託咪酯。輸註速度：A組0．9 mg/(kg·min),B組0．45 mg/(kg·min),C組0．23 mg/( kg·min)。患者入睡後,記錄肌陣攣的髮生情況,然後給予0．1 mg芬太尼,0．15 mg/kg順苯,併吸入6%七氟醚,2 min後給予插管。記錄輸註依託咪酯結束後1、5、8 min的MAP、HR。結果 B組肌陣攣的髮生率低于A組,但B組與C組比較差異無統計學意義,其中B組髮生肌陣攣的程度以1、2級為主,而A組和C組均以2、3級為主。給藥後5 min,三組患者MAP升高,給藥後8 min有所下降。三組心率比較差異無統計學意義。結論依託咪酯以一定的速度推註,可以減少肌陣攣的髮生率併減輕其髮生程度,本實驗的最適速度是0．45 mg/( kg·min)。
목적：연구의탁미지불동수주속도대전마환자기진련적영향。방법선취부과전마수술적환자90례,평균분성3조,매조30례,기록환자적입실평균동맥압( MAP)、심솔( HR)。개통정맥후,재유도기이불동적속도정맥수주총량위0．3 mg/kg적의탁미지。수주속도：A조0．9 mg/(kg·min),B조0．45 mg/(kg·min),C조0．23 mg/( kg·min)。환자입수후,기록기진련적발생정황,연후급여0．1 mg분태니,0．15 mg/kg순분,병흡입6%칠불미,2 min후급여삽관。기록수주의탁미지결속후1、5、8 min적MAP、HR。결과 B조기진련적발생솔저우A조,단B조여C조비교차이무통계학의의,기중B조발생기진련적정도이1、2급위주,이A조화C조균이2、3급위주。급약후5 min,삼조환자MAP승고,급약후8 min유소하강。삼조심솔비교차이무통계학의의。결론의탁미지이일정적속도추주,가이감소기진련적발생솔병감경기발생정도,본실험적최괄속도시0．45 mg/( kg·min)。
Objective To study the effect of different infusion rates of etomidate on myoclonus during general anesthesia. Methods 90 patients with general anesthesia gynecological surgery were divided into three groups. The mean arterial pressure (MAP),heart rate (HR) were recorded. After opening veins,patients of the three groups re-ceived intravenous infusion of 0. 3 mg/kg etomidate by different speeds. The infusion speed of group A,group B and group C were 0. 9 mg/( kg·min) ,0. 45 mg/( kg·min) and 0. 23 mg/( kg·min) . The patients′ myoclonus occurrences were recorded after falling asleep,then 0. 1 mg fentanyl and 0. 15 mg/kg cis-atracurium was injected,and 6%sevoflu-rane was inhaled. The intubation was done after 2 min. The blood pressure,mean arterial pressure ( MAP) and heart rate ( HR) at 1 min,5 min,8 min after injecting etomidate were recorded. Results The incidence of myoclonus in group B was lower than that of group A,no significant difference was found between group B and group C. The degree of myoclonus in patients of group B was 1~2,while the degree of group A and group C was 2~3. MAP of patients in-creased at 5 min after administration,and decreased at 8 min after administration. There was no significant difference in heart rate among the three groups. Conclusion Injecting etomidate at a certain speed can reduce the incidence and ex-tent of myoclonus. The best speed of this study was 0. 45 mg/( kg·min) .
