预处理对减少依托咪酯所致肌阵挛120例临床观察

Reduced by Pre-myoclonus Caused by Etomidate

目的:观察通过预处理对依托咪酯全麻诱导时肌阵挛的影响。方法:120例择期全麻患者随机分为3组:雷米芬太尼组、维库溴铵组和对照组,每组40例。观察各组全麻诱导时依托咪酯引起肌阵挛的例数,并记录肌阵挛的发生程度。结果:雷米芬太尼组出现3例肌阵挛(7.5%),其中轻度1例,中度2例;维库溴铵组出现2例轻度肌阵挛(5.0%);对照组出现30例肌阵挛(75.0%),其中轻度15例、中度12例、重度3例。雷米芬太尼组和维库溴铵组肌阵挛发生率明显低于对照组(P<0.01),而雷米芬太尼组和维库溴铵组间比较差异无统计学意义。结论:通过雷米芬太尼和维库溴铵预处理均可减少依托咪酯全麻诱导所致的肌阵挛,而因二者对心血管系统的影响不同,使用维库溴铵预处理更利于心血管系统功能降低的患者。

Objective：To observe the adoption of preconditioning on etomidate anesthesia induction myoclonus affected.Methods：120 cases of elective general anesthesia were randomly divided into three groups：remifentanil group,vecuronium group and the control group 40 cases.Observed in each group during anesthesia induction myoclonus caused by etomidate of the number of cases,and record the extent of the occurrence of myoclonus.Results：remifentanil group emerged three cases of myoclonus（7.5%）,of which 1 case mild,moderate,2 cases;vecuronium group of 2 patients with mild myoclonus（5.0%）;the control group there 30 cases of myoclonus（75.0%）,of which 15 patients with mild,moderate 12 cases and severe in 3 cases.Remifentanil group and vecuronium group myoclonus were significantly lower than the control group（P 0.01）,while the remifentanil group and vecuronium was no difference between the two groups statistically significant.Conclusions：remifentanil and vecuronium pretreatment can reduce etomidate induction of general anesthesia induced myoclonus,but because of the two different effects on the cardiovascular system,the use of vecuronium pretreatment more beneficial to the cardiovascular system function in patients with decreased.