咪唑安定和芬太尼对依托咪酯所致肌阵挛的影响

目的研究咪唑安定和芬太尼对依托咪酯所致肌阵挛的影响。方法全麻下行择期手术患者128例,根据麻醉诱导用药顺序和剂量的不同随机分为五组:Ⅰ组,咪唑安定0.05mg/kg、依托咪酯0.25mg/kg、芬太尼3μg/kg,22例;Ⅱ组,芬太尼3μg/kg、依托咪酯0.25mg/kg、咪唑安定0.05mg/kg,24例;Ⅲ组,咪唑安定0.05mg/kg、芬太尼3μg/kg、依托咪酯0.25mg/kg,32例;Ⅳ组,咪唑安定0.08mg/kg、依托咪酯0.25mg/kg、芬太尼3μg/kg,23例;Ⅴ组(对照组),依托咪酯0.25mg/kg、咪唑安定0.05mg/kg、芬太尼3μg/kg,27例。在静注依托咪酯后,观察并记录2min内肌阵挛阳性率及发生分级。结果五组肌阵挛阳性率分别为68.18%、41.67%、21.88%、21.74%、59.26%。与Ⅴ组比,Ⅲ、Ⅳ组肌阵挛阳性率及发生分级明显较低(P<0.05),Ⅰ、Ⅱ组肌阵挛阳性率及发生分级差异则无统计学意义。结论依次采用咪唑安定、芬太尼、依托咪酯诱导可减低依托咪酯引起的肌阵挛发生。

Effect of midazolam and fentanyl on etomidate-induced myoclonus

Objective To investigate the effect of midazolam and fentanyl on etomidate-induced myoclonus. Methods A total of 128 patients scheduled for surgery under genaral anesthesia were randomly divided into 5 groups according to the different sequence and dose of anesthetics during anesthesia induction. Midazolam 0. 05 mg/kg, etomidate 0. 25 mg/kg and fentanyl 3μg/kg was used in group Ⅰ, fentanyl 3 μg/kg, etomidate 0. 25 mg/kg, midazolam 0.05 rng/kg in group H,midazoIam 0. 05 mg/kg, fentanyl 3 μg/kg, etomidate 0. 25 mg/kg in group Ⅲ, midazolam 0. 08 mg/kg, etomidate 0. 25 mg/kg, fentanyl 3 μg/kg in group Ⅳ, etomidate 0. 25 mg/kg, midazolam 0. 05 mg/kg, fentanyl 3 μg/kg in group Ⅴ as the control After the injection of etomidate, the scales and positive incidences of myoclonus were observed within 2 minutes. Results The positive incidences of myoclonus were 68. 18% in group Ⅰ, 41.67% in group Ⅱ, 21.88% in group Ⅲ, 21.74% in group Ⅳ, and 59. 26% in group Ⅴ, respectively. Compared with group Ⅴ, groups of Ⅲ and Ⅳ had lower positive incidences and scales (P < 0. 05), whereas groups of Ⅰ and Ⅱ had no statistical changes in positive incidences and scales. Conclusion Using midazolarn, fentanyl, and etomidate consequently may reduce the occurrence of etornidate-induced myoclonus during anesthesia induction.