羟考酮预处理能同时减少快速顺序麻醉诱导中依托咪酯诱发的肌阵挛和罗库溴铵诱发的回避反应
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Pretreatment with Oxycodone Simultaneously Reduces Etomidate-Induced Myoclonus and Rocuronium-Induced Withdrawal Movements During RapidSequence Induction
背景与目的:依托咪酯和罗库溴铵通常被同时用于快速顺序诱导麻醉。然而，羟考酮预处理对肌阵挛和回避反应的影响并没有文献报道。本研究的目的是评估羟考酮预处理对快速顺序诱导麻醉中依托咪酯诱发的肌阵挛和罗库溴铵诱发的回避反应的发生率和严重程度的影响。
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方法：将120例患者随机分为盐水组（S组）和羟考酮组（O组）（每组60例）。 患者在给予0.3mg / kg依托咪酯前2分钟静脉给予0.05mg / kg羟考酮或生理盐水。 在依托咪酯给药后评价肌阵挛的发生率和严重程度，然后注射罗库溴铵，然后评价回避反应。
结果：依托咪酯和罗库溴铵连续给药后不随意运动发生的总频率O组明显低于S组（28.3％ vs 90％，p <0.001）。依托咪酯注射后肌阵挛发生的总频率和3级严重程度发生的总例数O组明显低于S组（总频率：25.0％ vs 63.3％; 3级严重程度的例数:0 vs 10，P <0.001）。罗库溴铵注射后回避反应发生的总频率和3级强度发生的总例数O组显着少于S组（总频率: 6.7％ vs 73.3％;3级强度的例数: 0 vs 11，P <0.001）。
结论：羟考酮预处理能同时有效预防全身麻醉诱导期间依托咪酯诱发的肌阵挛和罗库溴铵诱发的回避反应。
An X1, Li C1, Sahebally Z2, Wen X1, Zhao B1, Fang X1 Pretreatment with Oxycodone Simultaneously Reduces Etomidate-Induced Myoclonus andRocuronium-Induced Withdrawal Movements During Rapid-Sequence Induction. Med Sci Monit. Oct 19，2017 ;23:4989-4994.
Background: Etomidate and rocuronium are often paired in rapid-sequence anesthesia induction. However, the effect of pre-treatment with oxycodone on myoclonic and withdrawal movements has not been previously investigated. The aim of this study was to evaluate the effects of oxycodone on the incidence and severity of etomidate-in-duced myoclonus and rocuronium-induced nociceptive withdrawal movements during rapidsequence anesthe-sia induction.
Material/Methods: We randomly divided 120 patients into the saline group (group S) and the oxycodone group (group O) (n=60 in each group). Patients received 0.05 mg/kg oxycodone or saline intravenously 2 min before administration of 0.3 mg/kg etomidate. The occurrence and severity of myoclonus were assessed after administration of etomi-date, then rocuronium was injected, followed by evaluation of withdrawal movements.
Results: The total frequency of involuntary movements following sequential administration of etomidate and rocuronium was significantly lower in Group O than in Group S (28.3% vs. 90%, p<0.001). The total frequency and grade 3 severity of myoclonus following etomidate injection in Group O was significantly lower than in Group S (25.0% vs. 63.3% for total frequency; 0 vs. 10 for grade 3 severity, P<0.001). The total frequency and grade 3 intensi-ty of withdrawal movements were significantly less in Group O than in Group S (6.7% vs. 73.3% for total fre-quency; 0 vs. 11 for grade 3 intensity, P<0.001).
Conclusions:Oxycodone is effective for simultaneously preventing etomidate-induced myoclonus and rocuronium-induced withdrawal movements during general anesthesia induction.
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