预注苯磺顺阿曲库铵对芬太尼诱发咳嗽的影响

Effects of Intravenous Cisatracurium Besilate Pretreatment on Fentanyl-induced Cough

目的观察麻醉诱导前静脉预注苯磺顺阿曲库铵对芬太尼诱发咳嗽(fentanyl-induced cough,FIC)的抑制效果。方法200例患者随机分为2组,对照组(Ⅰ组)静脉注射生理盐水1 mL;苯磺顺阿曲库铵预处理组(Ⅱ组)注射苯磺顺阿曲库铵0.01 mg·kg-1,均采用左侧肘正中静脉注射;两组均于5 min后静脉注射芬太尼4μg·kg-1,注射时间2 s。记录两组患者咳嗽发生的次数和出现时间,并根据咳嗽发生次数进行严重程度分级。在注射生理盐水或苯磺顺阿曲库铵时、注射芬太尼时及注射后1、2 min分别记录血压、心率、呼吸和脉搏血氧饱和度及药物不良反应。结果两组患者性别构成差异无统计学意义(P>0.05)。两组比较,Ⅱ组芬太尼诱发咳嗽的发生率(19.0%,19/100)明显低于Ⅰ组(41.0%,41/100)(P<0.05);Ⅱ组芬太尼诱发中度和重度咳嗽患者为31.6%(6/19),明显少于Ⅰ组的56.1%(23/41)(P<0.05);咳嗽出现时间和血流动力学参数比较两组差异无统计学意义。结论苯磺顺阿曲库铵预处理能有效降低芬太尼诱发咳嗽的发生率和强度。

OBJECTIVE To observe the effect of intravenous cisatracurium besilate pretreatment on fentanyl-induced cough （FIC）. METHODS Totally 200 American Society of Anesthesiologists class I - II patients, aged 20 - 60 years within normal weight, scheduled for elective surgery, were randomly assigned to receive intravenous cisatracurium besilate 0. 01 mg. kg^-1（group 11 ） or normal saline （ group I ） 5 rain prior to the administration of fentanyl 4 μg . kg^- 1 in a randomized and double-blind fashion. Any episode of cough was classified as coughing, and graded as mild （1 -2）, moderate（3 -4）, or severe （5 or more）. We recorded the timing and severity of cough and monitored the vital signs and discomforts such as dizziness, tinnitus, nausea/vomiting, apnea and dysrhythmia. RESULTS The gender distribution showed no significant difference between two groups. The incidence of cough was 19.0% （19/100）in group ]] and 41% （41/100）in group I（P 〈 0. 05）. The incidence of moderate and severe cough was significantly higher in the group I （56. 1% ,23/41 ）than in group I （31.6% ,6/19） （P 〈0. 05）. There was no significant difference between these two groups in the timing of cough. Vital signs were stable in both groups and no difference was shown in discomforts. CONCLUSION Cisatracurium besilate pretreatment can effectively reduce the incidence and severity of FIC.