稀释和延长时间或预注丙泊酚对芬太尼引起咳嗽的影响

Effect of fentanyl with different injection technigues on fentanyl-induced coughing

目的观察稀释和延长注射时间或预注丙泊酚对芬太尼静注引起咳嗽的影响。方法175例拟行全麻患者,ASAⅠ或Ⅱ级,18～55岁,随机均分为五组:Ⅰ组,芬太尼50μg/ml,静脉3～5s内注完;Ⅱ组,芬太尼用生理盐水稀释成20μg/ml,3～5 s注完;Ⅲ组,芬太尼50μg/ml,静脉≥30 s内匀速注完;Ⅳ组,芬太尼用生理盐水稀释成20μg/ml,≥30 s内匀速注完;Ⅴ组,预注丙泊酚1～1.5mg/kg后1 min,按Ⅰ组方法和浓度静注芬太尼。五组芬太尼剂量均为3μg/kg。观察注射后咳嗽发生情况。结果Ⅳ组和Ⅴ组比Ⅰ组咳嗽显著减少(P<0.05或P<0.01)。Ⅱ组和Ⅲ组比Ⅰ组咳嗽有所减少,但差异无统计学意义。结论稀释和延长注射时间或预注丙泊酚可明显减少芬太尼静注时引起的咳嗽,预注丙泊酚效果更好。

Objective To study the effect of fentanyl with different injection technigues on fentanyl-induced cough. Methods One hundred and seventy-five patients undergoing general anesthesia were randomly allocated into five groups with 35 cases each. The concentration of fentanyl and injection time were 50 μg/ml and 3-5 s in group Ⅰ ,20 μg/ml and 3-5 s in group Ⅱ ,50μg/ml and ≥30 s in group Ⅲ ,20 μg/ml and ≥30 s in group Ⅳ. Propofol 1-1.5 mg/kg was given at 1 rain before fentanyl 50 μg/ml was administered as that in group Ⅰ. The dose of fentanyl was 3 μg/kg in all patients. To observe the state of cough after injection. Results Fentanyl-induced coughing was significantly less in groups Ⅳ and Ⅴ （11.4% and 3.0%） than that in group Ⅰ （34. 3%）（P〈0.05 or P〈0.01）. The severity of coughing was significantly less in group V than that in group Ⅰ （P〈 0. 05）. Conclusion Fentanyl-induced cough can be reduced by diluted solution and slow injection,and better by pre-injection of propofol.