依托咪酯在麻醉维持中的应用丁冠男祥解.pptVIP

肌颤预防 Pretreatment of rocuronium reduces the frequency and severity of Etomidate induced myoclonus. Journal of Clinical Anesthesia (2009) 20, 601–604. 实验组病人在给予0.3 mg/kg依托前3分钟使用0.06mg/kg的 罗库溴胺 在给予0.3 mg/kg依托咪酯前使用0.06mg/kg的罗库溴胺可 显著降低肌颤的发生率 Ⅰ组：静注咪唑安定2-3mg,Ⅱ组：静注阿曲库铵0.1mg／kg；Ⅲ组：静注芬太尼0.05 mg；Ⅰ-Ⅲ组分别在10-15s内静脉匀速注入，1 min 后Ⅰ-Ⅳ组分别给予依托咪酯0.3mg／kg 预静注咪唑安定、阿曲库铵或芬太尼均能明显的预防或减少依托咪酯诱导时引起的肌阵挛反应的发生率， 而三组比较以阿曲库铵组效果最好、芬太尼次之。 肌颤预防 不同方法预防依托咪酯诱导时肌阵挛的临床观察 实用医学杂志2010 年第26卷 第5 期 例病人 * 国外研究表明依托咪酯乳剂的注射痛发生率显著低于丙泊酚，这与两种药物本身的理化性质及其对溶媒的溶解性质有关。 Br J Anaesth. 2006; 97(4):536-9 Etomidate-Lipuro is associated with considerably less injection pain in children compared with propofol with added lidocaine. BACKGROUND: Propofol is associated with a high incidence of injection pain in children, even if given together with lidocaine. A new lipid formulation of etomidate (Etomidate-Lipuro) has been found in adults to cause very little discomfort during i.v. injection. The aim of the present prospective, double-blind, randomized trial was to compare the incidence of injection pain during i.v. induction of anaesthesia between propofol with added lidocaine (previous standard) and this new etomidate formulation in paediatric patients. METHODS: A total of 110 paediatric patients, aged 2-16 years, scheduled for outpatient surgery were planned to be included in the study. The primary end point of the study was the incidence of injection pain during induction of anaesthesia as assessed by a four-point scale as described previously. The occurrence of myoclonic muscular activity was registered as a secondary end point (four-point scale). An interim analysis after 80 patients was requested by the Ethics Committee. RESULTS: The study was stopped after the inclusion of 80 patients. A significantly lower incidence of injection pain was found in the Etomidate-Lipuro group as compared with the propofol-lidocaine group (5.0% vs 47.5%, P0.001). The use of etomidate was associated with a significantly higher inci