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目的 观察硫喷妥钠、咪唑安定、依托咪酯以及异丙酚麻醉诱导对琥珀胆碱引起的血钾升高、肌颤和肌痛的影响。方法 ASAⅠ～Ⅱ级病人 6 0例 ,随机分为四组 ,分别采用硫喷妥钠、咪唑安定、依托咪酯或异丙酚静脉诱导 ,静注琥珀胆碱后行气管插管。于诱导前、气管插管前和插管后测定血清钾浓度 ,并观察诱导期病人肌颤及术后病人肌痛的发生率。结果 各组病人诱导前及气管插管前的血钾浓度组间及组内比较均无明显差异 (P >0 .0 5 ) ,与诱导前相比 ,插管后硫喷妥钠组和依托咪酯组的血钾浓度分别升高 3.4%和 5 .3% (P <0 .0 1) ,咪唑安定组和异丙酚组的血钾浓度则无明显改变 (P >0 .0 5 )。异丙酚组和咪唑安定组肌颤和肌痛的发生率明显低于依托咪酯组和硫喷妥钠组 (P<0 .0 5 )。结论 咪唑安定和异丙酚能有效地防止琥珀胆碱引起的血钾浓度升高、肌颤和肌痛 ,而硫喷妥钠和依托咪酯则不能。
Objective To observe the effects of thiopental, midazolam, etomidate and propofol on induction of hyperkalemia induced by succinylcholine, muscle flutter and myalgia. Methods Sixty ASA Ⅰ ~ Ⅱ patients were randomly divided into four groups. They were induced by intravenous injection of thiopental, midazolam, etomidate or propofol respectively. Intrathecal injection of succinylcholine followed by tracheal intubation. Pre-induction, intubation and intubation before and after determination of serum potassium concentration, and to observe the induction of patients with postoperative muscle fibrillation and postoperative myalgia incidence. Results Before treatment and before tracheal intubation, there was no significant difference between before and after tracheal intubation (P> 0.05). Compared with pre-intubation thiopental group The serum potassium levels increased by 3.4% and 5.3% (P <0.001) in the imidacloprid group, but not in the midazolam and propofol groups (P> 0.05) . The incidence of fibrillation and myalgia in propofol and midazolam groups was significantly lower than those in etomidate and thiopental groups (P <0.05). Conclusions Midazolam and propofol can effectively prevent the increase of potassium concentration caused by succinylcholine, fibrillation and myalgia, while thiopental and etomidate can not.