摘要
目的比较右美托咪定与地佐辛抑制芬太尼诱发咳嗽反射的效果。方法将择期手术患者80例,ASAⅠ或Ⅱ级,随机分为两组:右美托咪定组(Ⅰ组)和地佐辛组(Ⅱ组),每组40例。Ⅰ组静脉输注右美托咪定1μg/kg,Ⅱ组静脉注射地佐辛0.1 mg/kg,10 min后两组采用芬太尼4μg/kg、丙泊酚1.5 mg/kg、咪达唑仑0.05 mg/kg和维库溴铵0.1 mg/kg进行麻醉诱导,芬太尼静脉注射时间<2 s。记录芬太尼注射后2 min内发生咳嗽次数和咳嗽程度。记录麻醉前(T0)、右美托咪定静脉输注或地佐辛静脉注射10 min后(T1)、芬太尼快速静脉注射后2 min(T2)的心率(HR)、脉搏氧饱和度(SpO2)和平均动脉压(MAP)。记录T0～T2期间的镇静评分(OAA/S)。结果与Ⅰ组比较,Ⅱ组咳嗽的发生率明显降低(P<0.05),两组咳嗽程度比较差异无统计学意义。与Ⅰ组比较,Ⅱ组T1时心率减慢不明显(P<0.05)。两组OAA/S比较差异无统计学意义。结论右美托咪定和地佐辛都可以有效地抑制芬太尼诱发的咳嗽反射,但地佐辛应用的效果更好且更安全。
Objective To compare the suppressive effect of intravenous dexmedetomidine and dezocine on fentanyl-induced cough during the induction of general anesthesia.Methods A total of 80 patients underwent elective surgery,ASA physical status Ⅰ-Ⅱ were randomized into two equally sized groups（n=40）.Patients in group Ⅰ received intravenous infusion of 1 μg/kg dexmedetomidine,while patients in group Ⅱ received intravenous injection of 1 μg/kg dezocine.Patients were induced with fentanyl 4 μg/kg,midazolam 0.05 mg/kg,propofol 1.5 mg/kg and vecuronium 0.1 mg/kg.The injection time of fentanyl was less than 2 s in all patients.The occurrence of cough was recorded 2 min after fentanyl injection.MAP,HR and SpO2 were recorded before the administration of dexmedetomidine or dezocine（T0）,10 min after intravenous dexmedetomidine or dezocine（T1） and 2 min（T2） later after fentanyl injection.Results The incidence of cough in group Ⅱ was significantly lower than that in groupⅠ（P＆lt;0.05）.There was no significant difference in the degree of cough between the two groups.Compared with group I,HR at T1 was not significantly lower in group Ⅱ（P＆lt;0.05）.There was no statistical significance in the degree of OAA/S between the two groups.Conclusion Intravenous dexmedetomidine and dezocine both can suppress fentanyl-induced cough,but dezocine can effectively and safely suppress the fentanyl-induced cough.
出处
《临床医学》
CAS
2013年第6期43-44,共2页
Clinical Medicine
