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静脉注射低剂量咪唑安定减少依托咪酯引起的肌阵颤：一项关于对行心脏复律治疗的患者的前瞻性，随机性研究

        研究背景：在未用术前药的病人，用依托咪酯进行全麻诱导而发生肌阵颤现象是一个普遍的问题。

        方法：在一个双盲研究中，40例行心脏复律治疗的患者（ASA分级III–IV级）随机分组，分别在静注0.3mg/kg的依托咪酯前90秒接受0.015mg/kg的咪唑安定或安慰剂注射。肌阵颤和镇静水平都在0至3分之间进行打分，脉搏氧饱和度，非有创性血压监测和心率都被记录。

        结果：在静注依托咪酯后，咪唑安定组有两例患者（10%）发生了肌阵颤现象，而对照组有20例患者（50%）发生了肌阵颤（P = 0.006）。两组间相比，没有显著性差异，尤其在注射依托咪酯后恢复的五分钟内两组间无差异。

        结论：在使用依托咪酯之前90秒静脉注射0.015mg/kg的咪唑安定能有效地减少肌阵颤的发生，而且在短小手术后会不延长未使用术前用药患者的恢复时间。

（论文出处：Anesth Analg 2007;105:1298 –302）

Low-Dose Intravenous Midazolam Reduces Etomidate-Induced Myoclonus: A Prospective, Randomized Study in Patients Undergoing Elective Cardioversion

研究背景: Myoclonic movements are a common problem in unpremedicated patients during induction of anesthesia with etomidate.

方法: In a double-blind fashion, 40 patients (ASA physical status III–IV) scheduled for elective cardioversion were randomly assigned to receive either 0.015 mg/kg midazolam or placebo 90 s before the injection of 0.3 mg/kg etomidate. Myoclonic movements and sedation were recorded on a scale between 0 and 3. Pulse oximetry, noninvasive arterial blood pressure, and heart rate were recorded during the study period.

结果: Two patients (10%) in the midazolam group had myoclonic movements after the administration of etomidate, whereas 10 of the 20 patients (50%) receiving placebo experienced such movements (P = 0.006). No other differences were found between the groups; in particular, there was no difference in recovery 5 min after the administration of etomidate.

结论: IV midazolam 0.015 mg/kg administered 90 s before induction of anesthesia with etomidate is effective in reducing myoclonic movements and does not prolong recovery in unpremedicated patients after short procedures.
(Anesth Analg 2007;105:1298 –302)