摘要
目的比较依托咪酯和丙泊酚在插入气管食管双通喉罩(PLMA)麻醉诱导时的优缺点。方法28例行择期手术的患者随机分为依托咪酯组(n=13)和丙泊酚组(n=15)。所有患者麻醉诱导前均静脉注射咪唑安定0.02mg/kg。依托咪酯组麻醉诱导用药依次为利多卡因1.5mg/kg、依托咪酯0.3mg/kg、芬太尼50μg;丙泊酚组为利多卡因1.5mg/kg、丙泊酚2mg/kg、芬太尼50μg。插入PLMA,观察注药至睫毛反射消失时间、注药至下颌松弛时间、注药至成功插入PLMA时间、PLMA成功插入的次数、是否发生呼吸抑制等。观察PLMA插入后患者是否出现咳嗽、呃逆、喉痉挛、体动等不良反应。记录患者HR、SBP、DBP在麻醉诱导前后的变化。结果两组睫毛反射消失时间、下颌松弛时间和成功插入PLMA时间差异无显著意义。依托咪酯组的呼吸抑制发生率明显低于丙泊酚组(P<0.05),但体动反射的发生率明显高于丙泊酚组(P<0.05)。两组患者在PLMA插入前后HR差异均无显著意义,依托咪酯组患者SBP、DBP在PLMA插入前后差异无显著意义。丙泊酚组患者SBP、DBP在PLMA插入后3、5min时明显下降(P<0.05)。结论依托咪酯0.3mg/kg复合利多卡因和芬太尼能够为插入PLMA提供良好的条件,并能保持血液动力学的稳定,但体动反应的发生率较丙泊酚高。
Objective To compare the effect of etomidate on proseal laryngeal mask（PLMA） insertion condition with propofol. Methods Twenty-eight patients scheduled for selective surgery were randomly allocated to two groups： etomidate group（n=13） and propofol group（n=15）. Midazolam 0.02 mg/kg were administrated before induction. After pre-oxygenation, anesthesia was induced with lidocaine 1.5 mg/kg, etomidate 0.3 mg/kg, fentanyl 50 μg （etomidate group）, or lidocaine 1.5 mg/kg, propofol 2 mg/kg, fentanyl 50μg （propofol group）. After insertion of PLMA, the times of lash reflex disappearance, jaw relaxation, successful insertion were assessed. Gagging, coughing, limbs movement, number of attempts at insertion were observed. HR, SBP and DBP were recorded before and after induction. Results There were no difference between two groups in the times of lash reflex disappearance, jaw relaxation, successful insertion. Compared with propofol group, the incidence of apnoea was significantly low in etomidate group, but that of limbs movement were relatively high. There were no difference in HR, SBP and DBP in etomidate group before and after induction, however, in propofol group, SBP and DBP were decreased compared with baseline. Conclusion Etomidate （0.3 mg/kg） combined with lidocaine and fentanyl is able to provide satisfied condition for PLMA insertion with stable hemodynamics, but the incidence of limbs movement is relatively higher than propofol group.
出处
《临床麻醉学杂志》
CAS
CSCD
2006年第5期337-339,共3页
Journal of Clinical Anesthesiology
