预注纳布啡对全麻诱导期依托咪酯诱发肌阵挛的影响(1)
[摘要] 目的 評价预注纳布啡对全麻诱导期依托咪酯诱发肌阵挛的影响。 方法 选择河南大学第一附属医院2018年6～9月择期在全麻下行泌尿外科手术治疗的成年患者64例，美国麻醉医师协会分级(ASA)Ⅰ～Ⅱ级，年龄30～63岁，采用随机数字表法分为纳布啡组(N组)和对照组(C组)，每组各32例。麻醉诱导前N组静注0.2 mg/kg纳布啡10 mL，C组静注等量生理盐水，150 s后两组均静注依托咪酯0.3 mg/kg。记录两组预处理前即刻(T0)、预处理后1 min(T1)、依托咪酯给药前即刻(T2)和依托咪酯给药后2 min(T3)的平均动脉压(MAP)、心率(HR)和血氧饱和度(SpO2)。记录依托咪酯给药后2 min内的肌阵挛发生情况并评估严重程度。记录依托咪酯给药前的恶心呕吐、心动过缓及低血压等不良反应的发生情况。 结果 N组仅出现3例轻度肌阵挛(9.4%);C组有23例出现不同程度的肌阵挛(71.9%)，其中轻度14例(43.8%)，中度8例(25%)，重度1例(3.1%)，N组肌阵挛发生率显著低于C组(P < 0.01)。两组不同时间点MAP、HR、SpO2的比较，差异均无统计学意义(均P > 0.05)。全麻诱导期间，两组恶心呕吐、心动过缓及低血压等不良反应发生率比较，差异均无统计学意义(均P > 0.05)。 结论 在静脉注射依托咪酯前150 s预注纳布啡0.2 mg/kg可有效抑制全麻诱导期依托咪酯诱发肌阵挛的发生。
[关键词] 纳布啡;依托咪酯;肌阵挛;麻醉
[中图分类号] R614 [文献标识码] A [文章编号] 1673-7210(2019)09(a)-0099-04
[Abstract] Objective To evaluate the effect of preinjection of Nalbuphine on Etomidate - induced myoclonus during induction of general anesthesia. Methods Sixty-four adult patients selected from the First Affiliated Hospital of He′nan University for Urological Surgery under general anesthesia from June to September 2018 were selected. The American society of anesthesiologists class Ⅰ -Ⅱ (ASA)， age range from 30 to 63. Random number table method was used to divide into Nalbuphine group (N group) and control group (C group)， 32 cases of each group. Before anesthesia induction， N group received 0.2 mg/kg Nalbuphine 10 mL， C group received an equal amount of normal saline， and after 150 s， both groups received 0.3 mg/kg Etomidate. The mean arterial pressure (MAP)， heart rate (HR) and oxygen saturation (SpO2) of the two groups were recorded immediately before pretreatment (T0)， 1 min after pretreatment (T1)， immediately before Etomidate administration (T2) and 2 min after Etomidate administration (T3). Myoclonic condition within 2 min after Etomidate administration was recorded and its severity was assessed. Adverse reactions such as nausea and vomiting bradycardia and hypotension before Etomidate administration were recorded. Results Only 3 cases (9.4%) of mild myoclonus in N group， while in group C， 23 cases (71.9%) had myoclonus of varying degrees， among them， 14 cases (43.8%) were mild， 8 cases (25%) of moderate and 1 case (3.1%) of severe. The incidence of myoclonus in N group was significantly lower than that in C group (P < 0.01). Comparison of MAP， HR and SpO2 at different time points in the two groups showed no statistically significant difference (P > 0.05). During the induction of general anesthesia， the incidence of adverse reactions such as nausea， vomiting， bradycardia and hypotension in the two groups showed no statistically significant difference (all P > 0.05). Conclusion Preinjection of 0.2 mg/kg of Nalbuphine 150 s before intravenous Etomidate injection can effectively inhibit the development of Etomidate induced myoclonus during the induction of general anesthesia., http://www.100md.com(任益锋 石薇 陈程哲 李会芳 牛晨光 郑孝振)
[关键词] 纳布啡;依托咪酯;肌阵挛;麻醉
[中图分类号] R614 [文献标识码] A [文章编号] 1673-7210(2019)09(a)-0099-04
[Abstract] Objective To evaluate the effect of preinjection of Nalbuphine on Etomidate - induced myoclonus during induction of general anesthesia. Methods Sixty-four adult patients selected from the First Affiliated Hospital of He′nan University for Urological Surgery under general anesthesia from June to September 2018 were selected. The American society of anesthesiologists class Ⅰ -Ⅱ (ASA)， age range from 30 to 63. Random number table method was used to divide into Nalbuphine group (N group) and control group (C group)， 32 cases of each group. Before anesthesia induction， N group received 0.2 mg/kg Nalbuphine 10 mL， C group received an equal amount of normal saline， and after 150 s， both groups received 0.3 mg/kg Etomidate. The mean arterial pressure (MAP)， heart rate (HR) and oxygen saturation (SpO2) of the two groups were recorded immediately before pretreatment (T0)， 1 min after pretreatment (T1)， immediately before Etomidate administration (T2) and 2 min after Etomidate administration (T3). Myoclonic condition within 2 min after Etomidate administration was recorded and its severity was assessed. Adverse reactions such as nausea and vomiting bradycardia and hypotension before Etomidate administration were recorded. Results Only 3 cases (9.4%) of mild myoclonus in N group， while in group C， 23 cases (71.9%) had myoclonus of varying degrees， among them， 14 cases (43.8%) were mild， 8 cases (25%) of moderate and 1 case (3.1%) of severe. The incidence of myoclonus in N group was significantly lower than that in C group (P < 0.01). Comparison of MAP， HR and SpO2 at different time points in the two groups showed no statistically significant difference (P > 0.05). During the induction of general anesthesia， the incidence of adverse reactions such as nausea， vomiting， bradycardia and hypotension in the two groups showed no statistically significant difference (all P > 0.05). Conclusion Preinjection of 0.2 mg/kg of Nalbuphine 150 s before intravenous Etomidate injection can effectively inhibit the development of Etomidate induced myoclonus during the induction of general anesthesia., http://www.100md.com(任益锋 石薇 陈程哲 李会芳 牛晨光 郑孝振)