Saricaoglu Fatma, Uzun Sennur, Arun Oguzhan, Arun Funda, Aypar Ulku
Department of Anesthesiology and Reanimation, Ankara, Turkey.
Saudi J Anaesth. 2011 Jan;5(1):62-6. doi: 10.4103/1658-354X.76509.
The purpose of this study was to compare etomidate-lipuro and propofol and 50%, (1:1) admixture of these agents at induction with special reference to injection pain, hemodynamic changes, and myoclonus.
Ninety patients were assigned at random to three groups in which induction was performed with either etomidate-lipuro, propofol or etomidate-lipuro-propofol admixture. After monitorization with bispectral index (BIS) all agents were given with infusion with a perfuser at a constant rate of 200 ml/min till the BIS values decreased to 40. Blood pressure and heart rate were measured every 30 s at this period. Patients were asked for pain at the injection site and observed visually for myoclonus. The time BIS values decreased to 40 (BIS 40 time) and total amounts of induction doses were measured.
BIS 40 time measurements were P > E > PE (199.4 ± 40.9, 176.9 ± 31.6, 163.5 ± 20.6 s). The hemodynamic (systolic, diastolic and mean blood pressures, heart rate) changes were minimal in group PE than other two groups (P = 0.017). The intensity of myoclonus was graded as mild in 9, moderate in 12, and severe in 5 patients in the group E (76.3%). Myoclonus was not observed in group PE and group P. There were no injection pain in group PE as the incidence were (83.8%) in group P and in (63.2%) group E.
Incidence of hemodynamic changes, myoclonus, and injection pain is significantly lower in group PE. BIS 40 times is least in group PE. We concluded that 1:1 admixture of etomidate-lipuro and propofol is a valuable agent for induction.
本研究旨在比较依托咪酯脂肪乳剂和丙泊酚以及这两种药物按50%（1:1）混合的合剂在诱导麻醉时的效果，特别关注注射痛、血流动力学变化和肌阵挛。
90例患者随机分为三组，分别用依托咪酯脂肪乳剂、丙泊酚或依托咪酯脂肪乳剂 - 丙泊酚混合剂进行诱导麻醉。在使用脑电双频指数（BIS）监测后，所有药物均通过输液泵以200 ml/min的恒定速率输注，直至BIS值降至40。在此期间，每隔30秒测量一次血压和心率。询问患者注射部位的疼痛情况，并通过肉眼观察肌阵挛。记录BIS值降至40的时间（BIS 40时间）和诱导剂量的总量。
BIS 40时间的测量结果为P > E > PE（199.4 ± 40.9、176.9 ± 31.6、163.5 ± 20.6秒）。与其他两组相比，PE组的血流动力学（收缩压、舒张压、平均血压、心率）变化最小（P = 0.017）。E组中，9例患者肌阵挛程度为轻度，12例为中度，5例为重度（76.3%）。PE组和P组未观察到肌阵挛。PE组无注射痛，P组的发生率为83.8%，E组为63.2%。
PE组血流动力学变化、肌阵挛和注射痛的发生率显著较低。PE组的BIS 40时间最短。我们得出结论，依托咪酯脂肪乳剂和丙泊酚按1:1混合是一种有价值的诱导麻醉药物。
