小剂量依托咪酯联合丙泊酚对全麻诱导效果的影响

Abstract
Figure/Table
References
Related Citation (15)

Download: PDF (597 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To investigate the effects of low-dose etomidate combined with propofol as a means of general anesthesia induction and observe the changes of hemodynamics, the depth of anesthesia and adverse reactions. Methods Ninety patients scheduled for general anesthesia in our hospital between October 2018 and February 2020 were enrolled. These patients were randomly divided into three groups, with 30 patients in each. The methods of anesthesia induction included propofol 2.0 mg/kg in group A, etomidate 0.3 mg/kg in group B, and etomidate 0.075 mg/kg + propofol 1.0 mg/kg in group C. MAP, HR, BIS were measured respectively before induction (T₀), before intubation(T₁), and 1,3 and 5 minutes (T_2-4) after intubation. Such adverse reactions as injection pain, myoclonus, hypertension, hypotension, and BIS<30 in each group were recorded. Results MAP in group C was higher than in group A at T_1-4, but was lower than in group B at T₂ (P<0.05). HR was lower in group C than in group B at T₂ (P<0.05), BIS in group C was lower than in group A at T_2-4, but was higher than in group B at T₂ and T₄(P<0.05). The incidence of injection pain and hypotension was lower in group C than in group A(0.0% vs. 36.7%,3.3% vs. 33.3%, P<0.05), so was the incidence of myoclonus(3.3% vs. 66.7%, P<0.05). The incidence of hypertension and BIS<30 was lower in group C than in group A and B(3.3% vs. 40.0%、70.0%,0.0% vs. 30.0%、60.0%, P<0.05). Conclusions After injection of etomidate for general anesthesia induction, propofol injected prior to tracheal intubation is a better agent for general anesthesia induction as evidenced by the stability of hemodynamics and the depth of anesthesia as well as lower incidence of adverse reactions.

Key words： propofol etomidate general anesthesia induction bispectral index

Received: 01 May 2021

ZTFLH:

R614.1

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	HU Keshi
	WANG Miaomiao
	YANG Meihua
	FENG Zeguo

Cite this article:

HU Keshi,WANG Miaomiao,YANG Meihua等. Efficacy of low-dose etomidate combined with propofol for general anesthesia induction[J]. Med. J. Chin. Peop. Armed Poli. Forc., 2021, 32(11): 954-957.

URL:

http://journal08.magtechjournal.com/Jwk_wjyx/EN/ OR http://journal08.magtechjournal.com/Jwk_wjyx/EN/Y2021/V32/I11/954

[1]	赵丽云,徐铭军,朱斌,等.心脏病患者非心脏手术围麻醉期中国专家临床管理共识(2020)[J].麻醉安全与质控,2021,5( 2):63-77.
[2]	Hannam J A, Mitchell S J, Cumin D, et al. Haemodynamic profiles of etomidate vs propofol for induction of anaesthesia: a randomised controlled trial in patients undergoing cardiac surgery[J]. Br J Anaesth, 2019, 122(2):198-205.
[3]	Devlin R J, Kalil D. Etomidate as an induction agent in sepsis[J]. Crit Care Nurs Clin North Am,2018,30(3):e1-9.
[4]	Jeon Y. Reduction of pain on injection of propofol: combination of nitroglycerin and lidocaine[J]. J Anesth, 2012, 26(5):728-731.
[5]	Dutta A, Sethi N, Sood J, et al. The effect of dexmedetomidine on propofol requirements during anesthesia administered by bispectral index-guided closed-loop anesthesia delivery system: a randomized controlled study[J]. Anesth Analg,2019, 129(1):84-91.
[6]	Abou M H, Rostrup M, Heier T. Dose requirements of alfentanil to eliminate autonomic responses during rapid-sequence induction with thiopental 4 mg/kg and rocuronium 0.6 mg/kg[J]. J Clin Anesth,2016, 35:465-474.
[7]	Hao L, Hu X, Zhu B, et al. Clinical observation of the combined use of propofol and etomidate in painless gastroscopy[J]. Medicine (Baltimore),2020, 99(45):e23061.
[8]	Soleimani A, Heidari N, Habibi M R, et al. Comparing hemodynamic responses to diazepam, propofol and etomidate during anesthesia induction in patients with left ventricular dysfunction undergoing coronary artery bypass graft surgery: a double-blind, randomized clinical trial[J]. Med Arch,2017, 71(3):198-203.
[9]	沈浩,高雪莹,曹江北,等.依托咪酯持续输注对患者术后生化指标的影响[J].临床麻醉学杂志,2019,35(10):995-998.
[10]	Zhu Y, Yang Y, Zhou C, et al. Using dezocine to prevent etomidate-induced myoclonus: a meta-analysis of randomized trials[J]. Drug Des Devel Ther,2017,11,2163-2170.
[11]	Yagan Ö, Taş N, Küçük A, et al. Haemodynamic responses to tracheal intubation using propofol, etomidate and etomidate-propofol combination in anaesthesia induction[J].Cardiovasc Thorac Res,2015,7(4):134-140.
[12]	Chen L, Liang X, Tan X, et al. Safety and efficacy of combined use of propofol and etomidate for sedation during gastroscopy: Systematic review and meta-analysis[J]. Medicine (Baltimore), 2019, 98(20): e15712.
[13]	王景华,王璇,王小鹏,等.无痛胃肠镜检查中应用依托咪酯-丙泊酚混合液的麻醉效果[J].武警医学,2020,31( 8):688-691.
[14]	Ye L, Xiao X, Zhu L. The comparison of etomidate and propofol anesthesia in patients undergoing gastrointestinal endoscopy: a systematic review and meta-analysis[J]. Surg Laparosc Endosc Percutan Tech,2017, 27(1):1-7.
[15]	Liu Y H, Qiu D J, Jia L, et al. Depth of anesthesia measured by bispectral index and postoperative mortality: a meta-analysis of observational studies[J]. J Clin Anesth, 2019, 56:119-125.
[16]	林博浩,罗天元,喻田,等.以GABAA受体为靶点的麻醉和镇静药的应用进展[J].临床麻醉学杂志,2020,36(3):304-307.
[17]	Kent D E, Savechenkov P Y, Bruzik K S, et al. Binding site location on GABAA receptors determines whether mixtures of intravenous general anaesthetics interact synergistically or additively in vivo[J]. Br J Pharmacol, 2019, 176(24):4760-4772.
[18]	Wang W, Lv J, Wang Q, et al. Oxycodone for prevention of etomidate-induced myoclonus: a randomized double-blind controlled trial[J]. Int Med Res,2018, 46(5):1839-1845.
[19]	Yates A M, Wolfson A B, Shum L, et al. A descriptive study of myoclonus associated with etomidate procedural sedation in the ED [J]. Am J Emerg Med, 2013, 31(5):852-854.
[20]	李杰,顾冰,毛广婷,等.脑电双频指数监测下不同麻醉深度对老年患者术后早期认知功能影响的Meta分析[J].中国老年学杂志,2020,40(5):992-997.
[21]	Zhou Y, Li Y, Wang K. Bispectral index monitoring during anesthesia promotes early postoperative recovery of cognitive function and reduces acute delirium in elderly patients with colon carcinoma: a prospective controlled study using the attention network test[J]. Med Sci Monit,2018, 24:7785-7793.
[22]	Kent D E, Savechenkov P Y, Bruzik K S, et al. Binding site location on GABAA receptors determines whether mixtures of intravenous general anaesthetics interact synergistically or additively in vivo[J]. Br J Pharmacol, 2019, 176(24):4760-4772.