布托啡诺预处理对无抽搐电休克治疗肌颤和肌痛影响.docVIP

布托啡诺预处理对无抽搐电休克治疗肌颤和肌痛的影响 　　作者：吴灵潝 邹捍东 余奇劲 刘忠纯 程邦昌 　　作者单位：430060武汉市武汉大学人民医院麻醉科(吴灵潝邹捍东、余奇劲)外科教研室(程邦昌) 　　【摘要】目的 观察布托啡诺预处理对精神病患者无抽搐电休克治疗(modified electroconvulsive therapy, MECT)肌颤和肌痛的影响。方法 选择我院MECT患者100例，随机分为对照组(n=60)和干预组(n=40)。对照组在异丙酚配伍琥珀胆碱麻醉下行MECT，监测心电、血压、呼吸和脑电发放情况，观察患者肌颤情况、自主呼吸恢复时间、苏醒时间和不良反应，并记录患者睁眼后即时(T0)、30 min(T1)、6 h(T2)的疼痛视觉模糊评分(VAS)和镇静评分(RSS)。干预组在麻醉前5 min静脉注射布托啡诺1 mg，余同对照组。结果 2组比较，自主呼吸恢复时间、苏醒时间、不良反应发生率、T0时的VAS和T0、T1、T2时的RSS差异无统计学意义(P0.05)。干预组肌颤发生率明显低于对照组，程度也明显减轻(P0.05);T1、T2时的VAS小于对照组(P0.05)。结论 布托啡诺预处理可有效减轻无抽搐电休克治疗的肌颤和肌痛。 　　【关键词】 预先给药 布托啡诺 无抽搐电休克治疗 肌颤 肌痛 　　Effect of butorphanol pretreatment on the muscle fasciculation and myalgia treated by modified electroconvulsive therapy WU Lingxi, ZOU Handong, YU Qijin, et al. Department of Anesthesiology, Peoples Hospital Affiliated to Wuhan University,Wuhan 430060,China 　　【Abstract】 Objective To investigate the influence of butorphanol pretreatment on the muscle fasciculation and myalgia treated by modified electroconvulsive therapy(MECT).Methods 100 psychotic patients who suffered from major depression or catatonic type schizophrenia were randomly divided into two groups: control group(n=60) and treatment group(n=40).The patients in control group were performed by MECT after anesthetizing with propofol and succinycholine intravenously.The MAP, HR, SPO2 of patients were recorded,and electroencephalogram,awakening time, recovery time of spontaneously breathing and adverse reactions were recorded too. The visual analogue scale(VAS), ramsay sedation scale(RSS) at T0(just after recovery), T1(30 min after recovery), T2(6 hours after recovery)were recorded. At the same time, the patients in treatment group were given with additional butorphanol(1 mg) five minutes before anesthesia.Results There were no significant differences in recovery time of spontaneously breathing, awakening time, incidence of adverse reactions, VAS(T0),RSS(T0,T1,T2) between two groups(P0.05).The incidence of muscle fasciculation in trea