小剂量罗库溴铵预处理对依托咪酯引发肌痉挛的影响

目的：观察小剂量罗库溴铵预处理对依托咪酯引发肌痉挛的影响。方法：选择100例择期行全麻手术患者，按随机数字表法均分为罗库溴铵组（R组）和氯化钠注射液组（S组）。R组患者给予罗库溴铵0．06mg／kg加入A．0．9％氯化钠注射液2ml中静脉注射，S组患者仅给予0．9％氯化钠注射液2ml静脉注射，给药后所有患者进行面罩给氧3L／min，3min后给予依托咪酯0．3mg／kg静脉注射。观察所有患者麻醉前后的无创血压（BP）、心率（HR）、血氧饱和度（SPO2）、心电图（ECG）的变化，肌痉挛发生率及不良反应发生情况；记录S组患者静脉注射依托咪酯1min后脑电双频指数（BIS）、表面肌电（EMG）的变化。结果：R组患者肌痉挛发生率显著低于S组，两组比较差异有统计学意义（P〈0．01）；S组患者发生Ⅰ、Ⅱ、Ⅲ级肌痉挛时EMG和BIS值均显著高于发生0级肌痉挛患者，差异有统计学意义（P〈0．01）；两组患者BP、HR、SPO2ECG均无明显变化，且治疗期间两组患者均未见明显不良反应发生。结论：小剂量罗库溴铵预处理可以显著降低依托咪酯引发的肌痉挛发生率，且安全性较好。

Effects of Small-dose Rocuronium Pretreatment on Etomidate-induced Myoclonus

OBJECTIVE： To observe the effects and safety of small-dose rocuronium pretreatment on etomidate-induced myoclonus. METHODS： 100 selective general anesthesia patients were randomly divided into rocuronium group （R group） and Sodium chloride injection group （S group）. R group was given 0.06 mg/kg rocuronium added into 0.9% Sodium chloride injection 2 ml intravenously; S group was given 0.9% Sodium chloride injection 2 ml intravenously. All patients received mask oxygen inhalation 3 L/min; and 0.3 mg/kg etomidate intravenously 3 min later. Non-invasive BP, HR, SPO2, ECG, myospasm and ADR were observed before and after anaesthesia. Bispectralindex （BIS） and electromyographic （EMG） activity were recorded in S group 1 min after intravenous injection of etomidate. RESULTS： The incidence of myospasm in R group was significantly lower than in S group; there was statistical significance （P〈0.01）. EMG and BIS of Ⅰ , Ⅱ and Ⅲdegree myospasm were significantly higher than 0 degree myospasm in S group; there was statistical significance （P〈0.01）. BP, HR, SPO2 and ECG had no significant change in 2 groups, and no obvious ADR was found in 2 groups during treatment. CONCLUSIONS： Small-dose rocuronium pretreatment can significantly reduce the incidence of etomidate-induced myospasm with good safety.