倍他米松用于芬太尼静脉诱导时咳嗽反射的临床观察

Effect of betamethasone on cough reflex induced by intravenous injection of fentanyl

目的:观察倍他米松预防芬太尼静脉诱导时咳嗽反射的效果。方法:100例择期全麻手术患者分为倍他米松组(10mg静脉注射)和对照组(等量生理盐水静脉注射)。均在右上肢远端建立外周静脉通道,给药后10min开始静脉诱导,两组芬太尼6μg/kg均在15s内匀速注入。观察指标:(1)各组患者从开始注射芬太尼至给药后2min内出现咳嗽的例数和强度变化;(2)观察各组麻醉前、给芬太尼后2min、给全麻药完后1min、气管插管后即刻、气管插管后5min时的HR、MAP、SpO2的变化。结果:倍他米松组咳嗽发生率为8.3%,与对照组(35%)相比有显著性差异。对照组轻、中、重度咳嗽发生率与倍他米松组各咳嗽强度组相比均有显著性差异。T1时段两组的HR、MAP相比有显著性差异。组内发生咳嗽反射患者与没出现咳嗽反射的患者相比HR、MAP明显升高,值也有所回升。结论:预先静脉注射倍他米松可有效降低麻醉诱导期间芬太尼所致咳嗽反射的发生。

Objective： To observe the effect of betamethasone on preventing cough reflex induced by intravenous injection of fentanyl. Methods： 100 cases of selective anesthesia patients were divided into betamethasone group （10 mg iv） and control group （10 mg saline iv）. Venous access was set up in the right upper distal limb, intravenous induction was started 10 min latter after administration, fentanyl was injected in 15 s at 6 μg/kg. The number of cough cases and intensity change of patients were observed in 2 rain after injection of fentanyl, and the changes of HR, MAP, SpO2 in the following time points were recorded：before anesthesia,2 min after fentanyl injection, 1 min after all anesthetics injection, right after intubation, 5 min after tracheal intubation. Results： The incidence of cough was 8.3% in betamethasone group, there was significant difference compared with the control group （35%）. There was significant difference in the incidence of mild, moderate, severe cough in control group compared with betamethasone group. There was significant difference in HR, MAP of two groups at T1 time. HR, MAP increased significantly in patients with cough reflex than no cough reflex, the value rised too. Conclusion： Injection of betamethasone in advance could effectively reduce cough reflex caused by fentanyl induction.