等效剂量阿芬太尼与芬太尼在全麻诱导时诱发咳嗽的对比研究

Comparison of cough induced by equivalent doses of alfentanil and fentanyl

目的:比较等效剂量阿芬太尼与芬太尼对患者咳嗽的影响。方法:50例全麻手术患者,随机分为阿芬太尼组、芬太尼组,每组25例,两组患者分别在5s内静脉注射阿芬太尼8μg/kg、芬太尼2μg/kg,观察给药后2min内两组患者的咳嗽起始时间、咳嗽发生率以及严重程度,并记录给药前(T1)和给药后2min(T2)两个时点的心率(HR)、平均动脉压(MAP)变化。结果:阿芬太尼组患者咳嗽的起始时间明显早于芬太尼组,阿芬太尼组咳嗽的发生率显著低于芬太尼组(P<0.05)。与T1时相比,T2时芬太尼组和阿芬太尼组的HR和MAP均显著下降(P<0.05),且阿芬太尼组HR和MAP下降程度显著低于芬太尼组(P<0.05)。结论:与等效剂量芬太尼相比,阿芬太尼诱发咳嗽的发生率较低,循环更为平稳。

AIM： To evaluate the effects of cough induced by equivalent doses of alfentanil and fentanyl. METHODS： Fifty patients under-going general anesthesia were randomly assigned to alfentanil group , and fentanyl group. Two groups were received equivalent doses of allen-tanil 8 μg/kg, and fentanil 2 μg/kg, via IV push within 5 seconds respectively. To observe the starting time , incidence and severity of cough, heart rate （HR） and mean arterial pressure （MAP） were recorded immediately before injec tion （T1） and 2 min （T2） after iniection. RE SULTS.. Alfentanil group had an earlier starting time than fentanyl group, alfentanil group had a significantly lower incidence of cough than fenta- nyl group （P 〈 0.05）. Compared with T1, the HR and MAP of alfentanil group and fentanylgroup at T2 were significant lower（P〈0.05）. Compared with fentanyl group, the extent of de- crease in the HR and MAP of alfentanil group were significant higher （P 〈0.05 ）. CONCLU SION： Alfentanil induces a lower incidence of cough and more steadier circulation than equiva- lent doses of fentanyl.