摘要
目的通过比较依托咪酯、异丙酚和依托咪酯—异丙酚混合液对注射痛、肌震颤和循环动力学改变的影响,探讨依托咪酯—异丙酚混合液在麻醉诱导中使用的安全性和有效性。方法将120例患者根据诱导期用药随机分为依托咪酯组(E组)、异丙酚组(P组)和依托咪酯—异丙酚混合液组(E-P组)各40例。所有药物均采用注射泵以200ml/min的速度泵注,直至患者意识消失。记录每分钟血压和心率的变化,记录意识消失的时间,以分级法记录患者注射痛和肌震颤的发生率以及麻醉诱导所使用的药物总量。结果 P组用药剂量明显高于E组和E-P组,且意识消失时间快于E组和E-P组,差异均有统计学意义(P<0.001)。P组注射痛发生率最高,E组次之,E-P组无注射痛发生,差异有统计学意义(P<0.01)。P组、E-P组均未观察到肌震颤,但E组观察到明显的肌震颤,评分分布为0级8例(20.0%)、1级17例(42.5%)、2级4例(10.0%)、3级11例(27.5%),差异有统计学意义(P<0.01)。与其他2组相比,E-P组血流动力学[收缩压(SBP)、平均动脉压(MBP)、心率(HR)]变化最小,3组间比较差异有统计学意义(P<0.05和P<0.01)。结论与单用依托咪酯和异丙酚相比,依托咪酯—异丙酚1:1混合液可消除注射痛和肌震颤,并维持良好的循环稳定性,是诱导期值得推荐的一种组合药物。
Objective To investigate the effect and safety of etomidate-Propofol mixture during induction of anesthesia by comparing the impact of etomidate,propofol and etomidate-propofol mixture on injection pain,myoclonus,and hemodynamic changes.Methods 120 patients were randomly divided into to etomidate group （group E）,propofol group （group P） and etomidate-propofol admixture （Group E-P）,each of 40 cases.All drugs were given with injection pump at a constant rate of 200 ml/min till loss of patients＇ consciousness.Blood pressure and heart rate were measured every 1min at this period.The time of loss of consciousness,the incidence of injection pain and myoclonus,and total drug doses during induction of anesthesia were measured.Results The total drug doses of group P was higher than that of group E and group E-P;the time of loss of consciousness of group P was shorter than that of group E and group E-P,and the differences were statistically significant （P0.001）.The incidence of injection pain of the group P was the highest,followed by group E,but there was no injection pain in group E-P,the differences were statistically significant （P0.01）.There was no myoclonus in group P and group E-P,but there was obviously myoclonus in group E,grade 0 in 8 cases（20.0%）,grade 1 in 17 cases（42.5%）,grade 2 in 4 cases（10.0%）,grade 3 in 11 cases（27.5%）,according to score distribution,the differences were statistically significant （P0.01）.Compared the other group,the hemodynamic （SBP,MBP and HR）changes were minimal,the differences were statistically significant （P0.05,P0.01）.Conclusion Compared with group P and group E,1：1 admixture of etomidate and propofol can eliminate injection pain and myoclonus and maintain good hemodynamic stability,which is a valuable combination drug for induction.of anesthesia.
出处
《临床合理用药杂志》
2013年第2期20-22,共3页
Chinese Journal of Clinical Rational Drug Use
