地佐辛抑制依托咪酯所致肌阵挛时对心率和平均动脉压影响的临床研究

目的:观察地佐辛抑制依托咪酯所致肌阵挛时对患者的心率和平均动脉压的影响。方法:选择120例择期全麻手术患者,将其随机分为对照组和实验组(地佐辛0.1 mg/kg),每组60例。在依托咪酯麻醉诱导前,实验组患者静脉注射地佐辛,对照组静脉注射等容积生理盐水。5分钟后,两组均静脉注射依托咪酯0.3 mg/kg麻醉诱导,记录和比较两组患者在给予地佐辛和生理盐水前(T0期)、给予地佐辛和生理盐水后5分钟(T1期)、给予依托咪酯后2分钟(T2期)的平均动脉压和心率的变化情况,并观察其有无肌阵挛及肌阵挛的程度。结果:对照组患者肌震颤的发生率为60%,实验组无患者发生肌震颤,两组比较差异有统计学意义(P0.01)。两组患者T2期平均动脉压均较同T0、T1期显著下降,但对照组和实验组患者T2期平均动脉压比较无显著差异(P0.05)。对照组T0、T1和T2三期心率无明显变化(P0.05),实验组T2期心率较T0和T1期明显下降,亦明显低于对照组T2期心率,且差异均具有统计学意义(P0.05)。结论:应用地佐辛预处理抑制依托咪酯麻醉诱导所致肌阵挛时,其对患者的平均动脉压无明显影响,可使心率减慢,但心率处于正常范围内。

The Clinical Research in the Influence of Dezocine on the Heart Rate andMean Arterial Pressure during the Inhibition of Myoclonus Induced byEtomidate

Objective:To investigate the influence of dezocine on mean arterial pressure and heart rate when it was used to preventmyoclonus caused by etomidate.Methods:120 patients who would accept selective operation under general anesthesia were randomlydivided into the experimental group (dezocine 0.1 mg/kg) and control group. Each group included 60 cases. Before anesthesia inductedby etomidate, the experimental group was intravenously injected with dezocine (diluted with normal saline to 5ml), and controlgroup received the same volume of saline. 5 minutes later, the two groups were intravenously injected with etomidate (0.3 mg/kg) foranesthesia induction. The mean arterial pressure and heart rate were recorded and compared between the two groups before injection withdezocine or saline (stage T0), 5 minutes after injection with dezocine or saline (stage T1), and 2 minutes after injection with etomidate(stage T2). Meanwhile, the incidence rate of myoclonus was observed.Results:The incidence rate of myoclonus was 60%in the controlgroup, which was significantly higher than that of the experimental group (0, P<0.01). The mean arterial pressures of experimental groupand control group were lower at T2 stage than those at T0 and T1 stage(P<0.05). No significant difference was found in the mean arterialpressure between two groups at T2 stage (P>0.05). No significant difference was found in the heart rate of control group between T0, T1and T2 stages(P>0.05). The heart rate of experimental group at T2 stage was significantly slower than those at T0 and T1 stage (P<0.05).The heart rate of experimental group was also slower than that of control group at T2 stage (P<0.05).Conclusion:Before anesthesia induction,dezocine was applied to inhibit myoclonus induced by etomidate. Dezocine had no remarkable effect on the patients'' mean arterialpressure, but it could make the heart rate slow, which was still in the normal range(>60 rates/min).