预注地佐辛对全麻诱导期依托咪酯导致肌阵挛的影响

Effect of intravenous dezocine on etomidate-induced myoclonus during general anesthesia induction:a prospective,randomized,double-blinded controlled trial

目的评估预注地佐辛对全麻诱导期依托咪酯导致肌阵挛的影响。方法选择108例患者，ASAⅠ或Ⅱ级，年龄20-65岁，全身麻醉下行择期手术。随机分为地佐辛组（D组）和对照组（S组），每组54例。患者预先给氧2min后D组静注地佐辛0．1mg／kg；S组给予相同容积生理盐水；1min后两组静注依托咪酯0．3mg／kg后持续观察2min肌阵挛发生情况和评估严重程度。监测患者生命体征及记录恶心、头晕、嗜睡等不良反应。结果D组无一例患者发生肌阵挛，明显低于S组41例（75．9％）（P〈0．01）。麻醉诱导期间两组患者的生命体征均平稳，未出现严重的低血压和心动过缓。结论预注0．1mg／kg地佐辛可有效减少全麻诱导期依托咪酯导致的肌阵挛发生。

Objective The aim of this prospective, randomized, double-blind controlled clinical trial was to evaluate the effects of pretreatment with dezoeine on the incidence and severity of etomidate-induced myoclonus. Methods A total of one hundred and eight ASA physical status Ⅰ or Ⅱ patients were randomly assigned to one of two groups to receive either 0.1 mg/kg of dezocine （group D, n=54） or saline （group S, n=54）. One minute after infusion of the study drug, etomidate 0. 3 mg/kg was given. The occurrence and severity （observational score of 0-3） of myoclonus was assessed in two minutes after administration of etomidate. Non-invasive blood pressure （BP）, SpO2 and HR were measured during the study period. Results The incidence and the intensity of myoclonus was significantly lower in the group D （0%） than in the group S （75.9%） （P〈0.01）. The cardiovascular system throughout the procedure was stable in both groups. No case had a problem with bradycardia or hypotension. Conclusion In our study, i.v. infusion of 0. 1 mg/kg dezocine 1 min before etomidate administration is an effective method for suppressing etomidate-induced myoclonic movements during general anesthesia induction.