静脉注射布托啡诺和依托咪酯对芬太尼诱发咳嗽的影响

Intravenous Butorphanol-Etomidate Pretreatment Reduces Fentanyl-induced Cough

目的观察麻醉诱导前静脉注射布托啡诺和依托咪酯对芬太尼诱发咳嗽(fentanyl-induced cough,FIC)的抑制效果。方法 200例患者随机分为对照组和布托啡诺和依托咪酯预处理组(实验组),2组患者性别构成差异无统计学意义(P>0.05)。对照组静脉注射生理盐水0.15 m L·kg-1和20%脂肪乳0.2 m L·kg-1;实验组注射布托啡诺15μg·kg-1和依托咪酯0.2 mg·kg-1,均采用左侧肘正中静脉注射;2组均于1 min后静脉注射芬太尼4μg·kg-1,注射时间2 s。记录2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。在注射生理盐水和脂肪乳或布托啡诺和依托咪酯时、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。结果实验组芬太尼诱发咳嗽的发生率(2.0%)明显低于对照组(36.0%)(P<0.05);实验组芬太尼诱发中度和重度咳嗽患者为0%,明显少于对照组的55.6%(20/36)(P<0.05);2组患者咳嗽出现时间比较差异无统计学意义。结论静脉注射布托啡诺和依托咪酯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 Butorphanol-etomidate pretreatment on the rate of fentanyl-induced cough（FIC）. METHODS Totally 200 American Society of Anesthesiologists scheduled for elective surgery, were randomly assigned to receive intravenous butorphanol 15 μg·kg-1 and etomidate 0.2 mg·kg-1（experimental group） or normal saline 0.15 m L·kg-1 and Intralipid 0.2 m L·kg-1（normal control group） 1 minutes prior to the administration of Fentanyl 4 μg·kg-1in a randomized and double-blind fashion. Any episode of cough was classified as difesent degree. Timing and severity of cough were recorded and monitored the vital signs and discomforts. RESULTS The incidence of cough was 2.0% in experimental group and 36% in normal control group（P〈0.05）.The incidence of moderate and severe cough was significantly higher in the normal control group（55.6%, 20/36） than in experimental group（0%）（P〈0.05）.There was no significant difference between these two groups in the timing of cough. CONCLUSION Butorphanol-etomidate pretreatment can effectively reduce the incidence and severity of FIC.