麻醉诱导时预注射小剂量右美托咪啶复合舒芬太尼对依托咪酯诱发肌痉挛的影响

夏瑞勇

【摘要】 目的：評价右美托咪啶复合舒芬太尼预注射对依托咪酯诱发患者肌阵挛的影响。方法：选取择期全麻手术患者240例，根据随机数字表法分为四组，每组60例。其中对照组（C组）、预注射舒芬太尼组（S组）、预注射右美托咪啶组（D组）和预注射右美托咪啶复合舒芬太尼组（DS组）。S组、D组及DS组分别预注射舒芬太尼、右美托咪啶及舒芬太尼+右美托咪啶后注射依托咪酯，注药完毕后2 min行气管插管，比较各组气管插管前肌痉挛发生率、发生强度及血流动力学变化。结果：四组肌阵挛发生强度比较，差异有统计学意义（P<0.05）;DS组、D组、S组肌痉挛发生率低于C组（P<0.05），D组、S组肌痉挛发生率及发生强度比较，差异无统计学意义（P>0.05），DS组肌痉挛发生率低于D组、S组（P<0.05）。插管前C组收缩压（systolic blood pressure，SBP）、舒张压（diastolic blood pressure，DBP）及心率（heart rate，HR）较诱导前升高（P<0.05），S组、D组及DS组较诱导前降低（P<0.05），插管前S组、D组及DS组之间SBP、DBP及HR比较，差异无统计学意义（P>0.05）。结论：麻醉诱导时序贯预注射小剂量右美托咪啶复合舒芬太尼，可明显降低依托咪酯诱发的肌阵挛发生率和肌阵挛程度。

【关键词】 依托咪酯; 肌阵挛; 麻醉; 右美托咪啶; 舒芬太尼

doi：10.14033/j.cnki.cfmr.2019.07.010 文献标识码 B 文章编号 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.