摘要
目的观察不同剂量的盐酸羟考酮预处理对依托咪酯全麻诱导时肌阵挛的影响。方法选择2014年5月～2015年1月于第二炮兵总医院择期全麻手术患者120例，将其随机分为A、B、c、D四组，每组各30例。A组患者于麻醉诱导前5min静脉注射生理盐水5mL作为对照组，B、c、D三试验组患者麻醉诱导前5rain分别静脉注射盐酸羟考酮注射液0．04、0．08、0．12m/kg（均用生理盐水稀释到5mL）预处理。观察并记录各组患者发生呼吸抑制的情况，5min后，四组患者均给予依托咪酯脂肪乳0．25mg／kg（注射时间为30s）进行麻醉诱导，观察各组患者给予依托咪酯后有无肌阵挛发生。结果A组患者发生肌阵挛的总数为12例（40．0％），B组8例（26．7％），C组2例（6．7％），D组1例（3．3％）；其中，B组与c、D两组患者比较差异均有统计学意义（P〈0．05），C组与D组比较差异无统计学意义（P〉0．05）。A组患者均未出现呼吸抑制，B组发生呼吸抑制2例（6.7％），C组4例（13．3％），D组12例（40．0％）；其中，B、c两组与D组患者比较差异均有统计学意义（P〈0．05），B、C两组比较差异无统计学意义（P〉0．05）。结论盐酸羟考酮预处理可减少依托咪酯全麻诱导时肌阵挛的发生率，其剂量为0．08mg／kg时效果好且呼吸抑制程度较轻。
Objective To observe the effects of myoclonus under different doses of oxycodone hydrochloride injection pretreatment on the induction of anesthesia with Etomidate. Methods A total of 120 cases from May 2014 to January 2015 undergoing genenal anesthesia in the Second Artillery General Hospital were randomly divided into four groups of A, B, C and D, 30 cases in each group. Group A, the control group, was given intravenously 5 mL normal saline 5 min- utes before induction of anesthesia; groups B, C and D were given 5 mL of pretreatment of oxycodone hydroehloride （in which the dose was respectively set as 0.04, 0.08, 0.12 mg/kg） 5 minutes before induction of anesthesia, the situationin of respiratory depression was recorded in the four groups. And then, patients of the four groups were given anesthesia of Etomidate fat emulsion of 0.25 mg/kg （in 30 seconds）, the situationin of myoclonus in the four groups was observed. Results 12 patients （40.0%） occurred myoclonus in group A, the number of group B was 8 （26.7%）, group C was 2 （6.7%）, group D was 1 （3.3%）. Among of them, group C and D were significantly different from group B （P 〈 0.05）, there was no statistically significant difference between group C and group D （P 〉 0.05）. None of patients occurred respiratory de- pression in group A, the number of patients with respiratory depression in group B was 2 （6.7%）, group C was 4 （13.3%）, group D was 12 （40.0%）. Group B and C were significantly different from group D （P 〈 0.05）, there was no statistically significant difference between group B and group C （P 〉 0.05）. Conclusion Myoclonus induced by Etomidate in induction of anesthesia can be prevented by pretreatment of oxycodone hydrochloride, with 0.08 mg/kg being the optimal dose.
出处
《中国医药导报》
CAS
2015年第16期124-127,共4页
China Medical Herald
作者简介
共同第一作者
共同第一作者
【通讯作者】李永旺（1971．5-），男，医学博士、博士后，硕士研究生导师，主任医师，副教授，中国医师协会麻醉学分会青年委员，全军麻醉与复苏委员会青年委员，国家自然科学基金评审专家，北京市自然科学基金评审专家；研究方向：全身炎性反应和心肺脑保护。
