麻醉誘導時預注射小劑量右美托咪啶復合舒芬太尼對依托咪酯誘發肌痙攣的影響

夏瑞勇

【摘要】 目的：評價右美托咪啶復合舒芬太尼預注射對依托咪酯誘發患者肌陣攣的影響。方法：選取擇期全麻手術患者240例，根據隨機數字表法分為四組，每組60例。其中對照組（C組）、預注射舒芬太尼組（S組）、預注射右美托咪啶組（D組）和預注射右美托咪啶復合舒芬太尼組（DS組）。S組、D組及DS組分別預注射舒芬太尼、右美托咪啶及舒芬太尼+右美托咪啶后注射依托咪酯，注藥完畢后2 min行氣管插管，比較各組氣管插管前肌痙攣發生率、發生強度及血流動力學變化。結果：四組肌陣攣發生強度比較，差異有統計學意義（P<0.05）;DS組、D組、S組肌痙攣發生率低于C組（P<0.05），D組、S組肌痙攣發生率及發生強度比較，差異無統計學意義（P>0.05），DS組肌痙攣發生率低于D組、S組（P<0.05）。插管前C組收縮壓（systolic blood pressure，SBP）、舒張壓（diastolic blood pressure，DBP）及心率（heart rate，HR）較誘導前升高（P<0.05），S組、D組及DS組較誘導前降低（P<0.05），插管前S組、D組及DS組之間SBP、DBP及HR比較，差異無統計學意義（P>0.05）。結論：麻醉誘導時序貫預注射小劑量右美托咪啶復合舒芬太尼，可明顯降低依托咪酯誘發的肌陣攣發生率和肌陣攣程度。

【關鍵詞】 依托咪酯; 肌陣攣; 麻醉; 右美托咪啶; 舒芬太尼

doi：10.14033/j.cnki.cfmr.2019.07.010 文獻標識碼 B 文章編號 1674-6805（2019）07-00-03

Effects of Preliminary Injecting Small-dose Dexmedetomidine Combined Sufentanil for Etomidate-induced Myoclonus during Anesthesia Induction/XIA Ruiyong.//Chinese and Foreign Medical Research，2019，17（7）：-24

【Abstract】 Objective：To investgate the effects of preliminary injecting small-dose Dexmedetomidine combined Sufentanil for Etomidate induced myoclonus during anesthesia induction.Method：A total of 240 cases of patients who would taken general anesthesia were selected and randomized into 4 groups，60 cases in each group，that were control group（CG），preliminary injecting Sufentanil group（SG），preliminary injecting Dexmedetomidine group（DG），preliminary injecting Sufentanil combined Dexmedetomidine group（DSG），Sufentanil Dexmedetomidine，Sufentanil combined Dexmedetomidine were preliminary injected before taking Etomidate in SG，DG and DSG，tracheal intubation were taken at 2 min after injection，incidence rate and intensity of myoclonus before tracheal intubation were contrasted.Result：There were significant differences in intensity of myoclonus among the four groups（P<0.05）.Incidence rate of myoclonus were lower in DSG，DG and SG than that in CG（P<0.05），incidence rate of myoclonus was indentical between DG and SG（P>0.05），Incidence rate of myoclonus were lower in DSG than that in DG and SG（P<0.05）.SBP，DBP and HR were higher in CG before tracheal intubation than before anesthesia induction（P<0.05），SBP，DBP and HR were lower in DSG，DG and SG before tracheal intubation than before anesthesia induction（P<0.05），and SBP，DBP and HR were identical along among DSG，DG and SG（P>0.05）.Conclusion：Preliminary injecting small-dose Dexmedetomidine combined Sufentanil during anesthesia induction can decrease incidence rate and intensity of Etomidate-induced myoclonus.