摘要
目的探讨不同剂量右美托咪定（DEX）用于无抽搐电休克治疗（MECT）对琥珀胆碱引起的肌震颤及术后肌痛的影响。方法选择2015-05-2015-09行MECT患者90例,随机分为高剂量DEX组、低剂量DEX组和对照组,每组30例。高剂量DEX组和低剂量DEX组分别于麻醉诱导前静脉匀速泵注DEX 0.6μg/kg和0.2μg/kg,泵注时间为10 min,对照组则给予等容量生理盐水（20 ml）。监测病人血压、心率、呼吸频率、血氧饱和度并记录注射琥珀胆碱后的肌震颤程度、电击后癫痫发作时间、自主呼吸恢复时间、苏醒时间,以及采用视觉模拟评分法（VAS）评估术后0.5 h（T1）、2 h（T2）、6 h（T3）肌痛情况。结果三组电击后癫痫发作时间、自主呼吸恢复时间、苏醒时间比较差异无统计学意义（P〉0.05）。肌震颤程度比较中,高剂量DEX组和低剂量DEX组比对照组明显减轻;且高剂量DEX组比低剂量DEX组程度减轻（P〈0.05）。术后肌痛程度比较,T1时三组的VAS评分比较差异无统计学意义（P〉0.05）;T2、T3时,高剂量DEX组VAS评分低于低剂量DEX组,并均低于对照组,差异有统计学意义（P〈0.05）。在低剂量DEX组和对照组中,T2、T3时的VAS评分明显高于T1时（P〈0.05）;在高剂量DEX组中,T1、T2、T3时的VAS评分比较差异无统计学意义（P〉0.05）。结论 DEX可以减轻MECT中因琥珀胆碱引起的肌震颤和术后肌痛程度,且0.6μg/kg较0.2μg/kg效果更为明显。
Objective To explore the effects of different doses of dexmedetomidine（ DEX） on succinylcholine-induced muscle fasciculation and postoperative myalgia after modified electric convulsive therapy（ MECT）. Methods Ninety patients were randomly divided into 3 groups： high dose DEX group,low dose DEX group and control group（ n = 30 in each group）. The patients were continuously infused intravenously with 0. 6 μg / kg DEX in high dose DEX group and 0. 2 μg / kg in low dose DEX group for 10 min before anesthesia,and the equal volume normal saline in control group（ 20 ml）. The blood pressure,heart rate,breathing rate and blood oxygen saturation were monitored. The onset time of seizure,autonomous respiration recovery time,and awakeness time were recorded. Besides,the muscle fasciculation was recorded after succinylcholine injection. The VAS scores of postoperative myalgia at 0. 5 h（ T1）,2 h（ T2）,6 h（ T3） were recorded after MECT. Results The onset time of seizure,autonomous respiration recovery time and awakeness time were not different among three groups（ P〈0. 05）. Compared with control group,the degree of muscle fasciculation in high dose DEX group and low dose DEX group were decreased significantly. Compared with low dose DEX group,the degree of muscle fasciculation in high dose DEX group decreased significantly（ P〈0. 05）. There was no significant difference in VAS scores at T1 among three groups（ P〈0. 05）. The VAS scores in high dose DEX group were lower than that in low dose DEX group at T2 and T3,and the scores in high dose DEX group and low dose DEX group were both lower than in control group（ P〈0. 05）. The VAS scores at T2 and T3were significantly higher than at T1 in low dose DEX group and control group（ P〈0. 05）,while the scores were not different in high dose DEX group at T1,T2 and T3（ P〉0. 05）. Conclusion DEX can decrease succinylcholine-induced muscle fasciculation and postoperative myalgia after MECT,and the dose of 0. 6 μg / kg is more eff
出处
《山西医科大学学报》
CAS
2016年第2期175-178,共4页
Journal of Shanxi Medical University
关键词
右美托咪定
无抽搐电休克疗法
肌震颤
肌痛
dexmedetomidine
modified electric convulsive therapy
muscle fasciculation
myalgia
