依托咪酯配伍硫酸镁在临床麻醉中的应用研究进展

Research progress on compatibility of etomidate with magnesium sulphate

依托咪酯是非巴比妥类的静脉麻醉药,对呼吸和循环影响轻微,但是依托咪酯有注射痛、肌阵挛、术后恶心呕吐、抑制肾上腺皮质功能等不良反应,尤其肌阵挛的发生率较高。临床上有许多药物可用于抑制依托咪酯引起的肌阵挛,例如阿片类、苯二氮艹卓类,但易引起术后呼吸抑制和苏醒延迟。与以上药物相比,硫酸镁既不会引起呼吸抑制,也不会产生镇静作用,更不会引起苏醒延迟。硫酸镁是否能够降低依托咪酯引起肌阵挛的发生率以及合适剂量,值得临床进一步研究与探讨。本研究就依托咪酯和硫酸镁各自的药理作用特点和临床应用进行综述,探讨依托咪酯配伍硫酸镁在临床麻醉中应用的可能性。

Etomidate is described as a new induction agent with very rare cardiopulmonary side effects but sev- eral disturbing side effects, such as pain on injection, myoclonus, postoperative nausea and vomiting, and adrenal sup- pression. Myoclonus is still a common problem, different kinds of drugs had been investigated as pretreatment drugs be- fore iduction of anesthesia with etomidate as a means of preventing myoclonus. However there is unwanted effects in- cluding respiratory depression, sedation and so on. Whether magnesium sulfate could reduce the incidence of myoclonus and how much doses of magnesium sulfate could significantly reduce the occurrence of myoclonus deserves needed further clinical research and discussion. In this paper, the pharmacological effects and clinical application of the latest re- search about etomidate and magnesium are summarized as follows.