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丙泊酚与依托咪酯用于麻醉诱导的比较

[Induction of anesthesia using propofol in comparison with etomidate].

作者信息

Ulsamer B, Raps M

机构信息

Institut für Anaesthesiologie, Ludwig-Maximilians-Universität, Bereich Poliklinik, München.

出版信息

Anaesthesist. 1988 Aug;37(8):517-21.

PMID:3052168
Abstract

Etomidate and propofol were compared for induction of anesthesia in a controlled study, including 24 male patients (ASA groups I and II). Following oral premedication with lormetazepam, the patients received propofol (2.5 mg kg-1; n = 12) or etomidate (0.3 mg kg-1; n = 12) over 60 s. For statistical analysis of the cardiovascular data (blood pressure and heart rate) four blocks were set up: A, baseline value including atropine dosage; B, value after induction of anesthesia; C, value after administration of halothane and vecuronium before intubation; D, value after intubation. The blood pressure fell slightly on administration of propofol while the heart rate remained nearly unchanged. Etomidate was associated with unacceptably high increases in blood pressure and heart rate. Myoclonia occurred in seven patients after etomidate and in two patients after propofol. A smoother mask ventilation was rated as a further advantage of propofol. Because of the unfavorable cardiovascular profile, the occurrence of myoclonia and poor mask ventilation, etomidate proved to be unsuitable for induction of anesthesia unless supplemented by an opioid and/or benzodiazepine. The high incidence of pain upon injection was considered to be a disadvantage of propofol.

摘要

在一项对照研究中,对依托咪酯和丙泊酚用于麻醉诱导进行了比较,该研究纳入了24例男性患者(ASA分级为I级和II级)。在口服氯美扎酮进行术前用药后,患者在60秒内接受丙泊酚(2.5mg/kg;n = 12)或依托咪酯(0.3mg/kg;n = 12)。为了对心血管数据(血压和心率)进行统计分析,设置了四个时间段:A,包括阿托品剂量的基线值;B,麻醉诱导后的数值;C,插管前给予氟烷和维库溴铵后的数值;D,插管后的数值。给予丙泊酚后血压略有下降,而心率几乎保持不变。依托咪酯与血压和心率不可接受的大幅升高有关。依托咪酯给药后7例患者出现肌阵挛,丙泊酚给药后2例患者出现肌阵挛。丙泊酚的另一个优点是面罩通气更顺畅。由于心血管反应不佳、出现肌阵挛以及面罩通气不良,除非补充阿片类药物和/或苯二氮䓬类药物,否则依托咪酯被证明不适合用于麻醉诱导。注射时疼痛发生率高被认为是丙泊酚的一个缺点。

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