不同剂量右美托咪啶预防全麻诱导期芬太尼呛咳反应的效果

The effect of different doses of dexmedetomidine on patients to prevent fentanyl-induced cough during anesthesia induction

目的:评价预前输注不同剂量右美托咪啶预防全麻诱导期芬太尼诱发患者呛咳反应的效果。方法:择期行全麻腹式子宫肌瘤剔除术或子宫全切术患者300例。将患者随机分为5组(n=60):对照组(C组):生理盐水组;不同剂量右美托咪啶组D1～D4组:分别以0.1、0.25、0.5、1.0μg/kg于麻醉诱导前用生理盐水配制至10 ml,均以1 ml/min的速率匀速输注,输注完毕后随即静脉注射芬太尼4μg/kg,注射时间为2 s。记录芬太尼注射后1 min内呛咳反应的发生率及程度。结果:与C组相比,D1～D4组呛咳发生率降低(P<0.05),严重心动过缓发生率逐渐升高(P<0.05)。D4组2例发生低血压,且5组低血压发生率无统计学意义(P>0.05)。D1～D4组间呛咳发生率及严重程度比较差异无统计学意义(P>0.05)。结论:预前输注右美托咪啶0.1μg/kg可有效、安全地抑制芬太尼引发的呛咳反应。

Objective： To investigate the effect of doses of dexmedetomidine on patients to prevent fentanyl-induced cough during anesthesia induction. Methods： A total of 300 patients, scheduled for elective myomectomy or abdominal totai hysterectomy under general anesthesia, was randomly derided into 5 groups （n = 60） ： Control group（ group C） received infusion of 10 ml isotonic saline and treated groups（ D1 to D4 ） were dexmedetomidine 0.10,0. 25,0. 5,1. 0 tμ/kg, over 10 min, before anesthesia induction. All groups subsequently received a fentanyl （4 μg/kg ） intravenous push,over 2 s. The incidence and degree of cough were recorded within 1 min after fentanyl injection. Results： Compared with group C, the incidence of cough in D1 - D4 groups were decreased, while the incidence of severe sinus bradycardia increased in D1 - D4 groups （ P 〈 0.05 ）. There were two humans having hypotension in D4 group. There was no significant difference in the incidence and the degree of the fentanyl-iuduced cough in D1 ～ D4 groups. Conclusion ： The iufusion of dexmedetomidine 0. 1μg/kg can effectively and savely prevent fentanyl-iuduced cough during anethesia induction.