鼻内滴入舒芬太尼减少依托咪酯所致肌阵挛

Intranasal instillation of sufentanil reduces myoclonus induced by etomidate

目的研究鼻内滴入舒芬太尼预处理对依托咪酯引发肌阵挛的效果。方法选择ASAI或Ⅱ级,年龄32-70岁,体重50-85 kg,无神经肌肉传导功能障碍疾病的择期手术患者80例,随机分为A、B两组,A组：鼻腔内滴入舒芬太尼0.2μg.kg^-1,舒芬太尼用生理盐水稀释至1 ml;B组：鼻内滴入等量的生理盐水,两组均在滴鼻2 min后静脉注射依托咪酯0.3 mg.kg^-1,记录滴鼻前即刻（T0）、滴鼻结束后1 min（T1）、2 min（T2）的MBP、HR、SPO2和RR,观察有无肌阵挛的发生,记录肌阵挛程度并评分。结果与B组相比,A组依托咪酯引发肌阵挛程度降低（P〈0.01）,各组同一时点的MBP、HR、SPO2、RR差异无统计学意义。结论鼻内滴入舒芬太尼0.2μg.kg^-1能显著降低依托咪酯引发的肌阵挛,对呼吸系统和循环系统无明显影响。

Aim To investigate the effects of intranasal sufentanil reducing myoclonus induced by etomidate.Methods Eighty ASA class I or Ⅱ patients aged 32 to 70 years weighing 50 to 85 kg without neuromuscular dysorders who were undergoing elective surgery were randomly divided into two groups：Group A received intranasal instillation of sufentanil 0.2 μg·kg-1,which was diluted to 1 ml.Group B received intranasal instillation of normal saline l ml,After 2 min,two groups were injected etomidate 0.3 mg·kg-1.MBP,HR,SPO2 and RR were recorded before intranasal instillation of sufentanil（T0）,at 1 min（T1） and 2 min（T2）after intranasal instillation of sufentanil.Myoclonus was observed and graded.Results The incidence of myoclonus was significantly lower in group A than that in group B（P〈0.01）.There was no significant difference in MBP,HR,SPO2 and RR at all time points between group A and group B.Conclusion Intranasal instill ation of sufentanil 0.2 μg·kg-1 can reduce myoclonus induced by etomidate.