摘要
目的观察右美托咪定滴鼻对依托咪酯诱发肌阵挛的影响。方法选择ASA分级I～Ⅱ级的择期手术患者100例，按随机数字表法分为两组，每组50例，分别在麻醉诱导前用右美托咪定1μg／kg滴鼻（右美托咪定组）或等量0．9％氯化钠滴鼻（对照组），30min后两组均静脉注射依托咪酯0．3mg／kg，记录滴鼻前（To）及滴鼻后15min（T1）、30min（T2）的平均动脉压（MAP）、心率、脉搏血氧饱和度（SpO2）和呼吸频率，观察肌阵挛发生情况并评级。结果右美托咪定组T2时MAP、心率低于rr0时[（75．9±8．1）mmHg（1mmHg=0．133kPa）比（81．4±10．4）mmHg、（80．9±7．6）次／min比（85．9±9．1）次／min]，差异有统计学意义（P〈0．05），但均在正常范围内；其他各时间点组内、组间比较差异均无统计学意义（P〉0．05）。右美托咪定组肌阵挛发生率明显低于对照组[42％（21／50）比70％（35／50）]，差异有统计学意义（P〈0．01）。结论右美托咪定滴鼻可安全有效地减少依托咪酯诱发的肌阵挛。
Objective To observe the effect of intranasal dexmedetomidine on preventing myoclonus induced by etomidate. Methods One hundred patients who ASA classification I - II grades were divided into two groups by random digits table method with 50 cases each. Before anesthesia induction with dexmedetomidine 1 μg/kg （dexmedetomidine group） or equivalent 0.9% sodium chloride （control group） intranasal, 30 min after two groups were injected etomidate 0.3 mg/kg. Mean artery pressure（MAP）, heart rate （HR）, oxygen saturation with pulse oximetry （SpO：） and respiratary rate were recorded before intranasal instillation of dexmedetomidine （T0）,at 15 min （%） and 30 min （T2） after intranasal dexmedetomidine, myoclonus was observed and graded. Results The MAP, HR at T2 was lower than that at To in dexmedetomidine group [ （ 75.9 ＋ 8.1 ） mm Hg （ 1 mm Hg = 0.133 kPa） vs. （ 81.4 ＋ 10.4） mm Hg, （80.9 ＋ 7.6） times/rain vs. （85.9 ＋ 9.1 ） times]mini, there was significant difference （P 〈 0.05）, but all within the normal range; other within the group at each time point had no statistical significance between two groups （P 〉 0.05）. The incidence of myoelonus was significantly reduced in dexmedetomidine group compared with that in control group [42%（21/50） vs. 70%（35/50）] ,there was significant difference （P 〈 0.01）. Conclusion Intranasal instillation of dexmedetomidine can safely prevent myoclonus induced by etomidate.
出处
《中国医师进修杂志》
2013年第27期30-32,共3页
Chinese Journal of Postgraduates of Medicine
