中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2013年
5期
11-12
,共2页
康振明%谢文钦%谢文吉%江长城%赵桀
康振明%謝文欽%謝文吉%江長城%趙桀
강진명%사문흠%사문길%강장성%조걸
右美托咪定%咪达唑仑%依托咪酯%麻醉%全身%肌阵挛
右美託咪定%咪達唑崙%依託咪酯%痳醉%全身%肌陣攣
우미탁미정%미체서륜%의탁미지%마취%전신%기진련
Dexmedetomidine%Midazolam%Etomidate%Anesthesia%General%Myoclonus
目的:对比观察右美托咪定与咪达唑仑预处理对依托咪酯诱导时肌阵挛的影响.方法:选择120例 ASA 为Ⅰ~Ⅱ级妇科全麻手术患者,随机分为右美托咪定组、咪达唑仑组和对照组,每组各40例;分别静注右美托咪定0.5μg/kg(4μg/ml)、咪达唑仑0.03 mg/kg (0.24 mg/ml)和等量(0.125 ml/kg)生理盐水(5 min 注射完毕).5 min 后,静脉注射依托咪酯0.3 mg/kg(1 min 注射完毕),观察并记录有无肌阵挛发生及肌阵挛的严重程度.结果:右美托咪定组和咪达唑仑组分别经静脉预先注射0.5μg/kg 和0.03 mg/kg 后,再给予依托咪酯诱导时肌阵挛的发生率分别为5%和7.5%,而对照组肌阵挛的发生率为55%,差异有统计学意义(P<0.01).结论:以右美托咪定0.5μg/kg和咪达唑仑0.03 mg/kg 预处理都可明显降低依托咪酯诱导时肌阵挛的发生率,且两者预处理的效果相当.右美托咪定在辅助麻醉方面具有镇静、镇痛,减少麻醉剂用量、稳定血流动力学、无呼吸抑制等特点,更适合与依托咪酯联合使用作为全麻诱导用药.
目的:對比觀察右美託咪定與咪達唑崙預處理對依託咪酯誘導時肌陣攣的影響.方法:選擇120例 ASA 為Ⅰ~Ⅱ級婦科全痳手術患者,隨機分為右美託咪定組、咪達唑崙組和對照組,每組各40例;分彆靜註右美託咪定0.5μg/kg(4μg/ml)、咪達唑崙0.03 mg/kg (0.24 mg/ml)和等量(0.125 ml/kg)生理鹽水(5 min 註射完畢).5 min 後,靜脈註射依託咪酯0.3 mg/kg(1 min 註射完畢),觀察併記錄有無肌陣攣髮生及肌陣攣的嚴重程度.結果:右美託咪定組和咪達唑崙組分彆經靜脈預先註射0.5μg/kg 和0.03 mg/kg 後,再給予依託咪酯誘導時肌陣攣的髮生率分彆為5%和7.5%,而對照組肌陣攣的髮生率為55%,差異有統計學意義(P<0.01).結論:以右美託咪定0.5μg/kg和咪達唑崙0.03 mg/kg 預處理都可明顯降低依託咪酯誘導時肌陣攣的髮生率,且兩者預處理的效果相噹.右美託咪定在輔助痳醉方麵具有鎮靜、鎮痛,減少痳醉劑用量、穩定血流動力學、無呼吸抑製等特點,更適閤與依託咪酯聯閤使用作為全痳誘導用藥.
목적:대비관찰우미탁미정여미체서륜예처리대의탁미지유도시기진련적영향.방법:선택120례 ASA 위Ⅰ~Ⅱ급부과전마수술환자,수궤분위우미탁미정조、미체서륜조화대조조,매조각40례;분별정주우미탁미정0.5μg/kg(4μg/ml)、미체서륜0.03 mg/kg (0.24 mg/ml)화등량(0.125 ml/kg)생리염수(5 min 주사완필).5 min 후,정맥주사의탁미지0.3 mg/kg(1 min 주사완필),관찰병기록유무기진련발생급기진련적엄중정도.결과:우미탁미정조화미체서륜조분별경정맥예선주사0.5μg/kg 화0.03 mg/kg 후,재급여의탁미지유도시기진련적발생솔분별위5%화7.5%,이대조조기진련적발생솔위55%,차이유통계학의의(P<0.01).결론:이우미탁미정0.5μg/kg화미체서륜0.03 mg/kg 예처리도가명현강저의탁미지유도시기진련적발생솔,차량자예처리적효과상당.우미탁미정재보조마취방면구유진정、진통,감소마취제용량、은정혈류동역학、무호흡억제등특점,경괄합여의탁미지연합사용작위전마유도용약.
Objective:To compare the clinical effects of pretreatment with dexmedetomidine and midazolam in prevention of myoclonus after in general anesthesia induction using etomidate. Method:120 elective patients,ASA grade I~II,undergoing gynecology surgery under general anesthesia were randomly allocated to three groups with 40 cases each. Dexmedetomidine Group(n= 40)received dexmedetomidine 0.5μg/kg,Midazolam group(n=40) received midazolam 0.03 mg/kg and control group(n=40)received the same volume normal saline. All the patients were given etomidate(0.3 mg/kg)5 minute after pretreatment. The onset of myoclonus was observed and the severity was recorded. Result:Twenty-two patients(55%)in the control group had myoclonus after etomidate injection compared to 2(5 %)and 3(7.5 %)in the dexmedetomidine and midazolam groups ,respectively(P<0.05). Conclusion:Pretreatment with dexmedetomidine 0.5μg/kg and midazolam 0.03 mg/kg can greatly reduce myoclonus after etomidate induction,and the effects are similar. In view of dexmedetomidine in anesthesia of other,more suitable for the joint of etomidate as an anesthetic induction agents .
