静脉输注舒芬太尼抑制气管拔管时咳嗽反应的临床研究

Clinical study on sufentanil infusion before extubation for supressing coughing

目的：探讨麻醉苏醒期输注舒芬太尼对气管拔管时咳嗽反应的影响。方法81例患者随机分为3组。在术毕拔管前S1组输注舒芬太尼0.2μg/（kg·h）,S2组输注舒芬太尼0.3μg/（kg·h）,C组输注等容量的生理盐水。记录咳嗽分级,平均动脉压（MAP）和心率（HR）,苏醒时间,术后1 h,6 h和24 h的疼痛评分,镇痛药用量,术后恶心呕吐（PONV）评分。结果与C组比较S1和S2组在拔管时咳嗽评分和MAP、HR降低；三组苏醒时间无显著差异；与控制组比较S1和S2组术后1h疼痛、PONV评分、镇痛药用量显著降低。结论拔管前舒芬太尼以（0.2~0.3）μg/（kg·h）的速率输注可抑制患者拔管时的咳嗽反应,降低镇痛药物需要量,不延长拔管时间,不增加PONV。

Objective To evaluate whether sufentanil infusion during emergence anesthesia has a effect of coughing on extubation. Methods Eighty-one patients were randomly divided into three groups. before extubation, sufentanil was administered at the group S1 at a rate of 0.2μg/（kg·h）or 0.3μg/（kg·h）at the group S2, and saline was administered to the group C. Cough score, MAP, HR and recovery profiles were recorded. The pain score, the total volume of admin-istered patient-controlled analgesia（PCA）, and the postoperative nausea and vomiting（PONV） score were evaluated at 1, 6, and 24 hours after surgery. Results Compared to Group C ,Groups S1 and S2 showed significantly lower cough scores and MAP, HR on extubation. Recovery profiles showed no significant differences among the three groups. Pain score, PONV at 1 hour postoperatively, and the total volume of PCA administered at all evaluation times were signifi-cantly lower in the groups S1 and S2 than in the group C. Conclusion A sufentanil infusion（0.2~0.3）μg/（kg·h） dur-ing emergence anesthesia may suppress coughing on extubation without delaying extubation time. It may also reduce the postoperative analgesic requirement without increasing PONV.