羟考酮与地佐辛预防麻醉诱导时芬太尼诱发咳嗽反应效果的比较

Comparison of oxycodone and dezocine for prevention of fentanyl-induced cough during anesthesia induction

目的比较羟考酮与地佐辛对芬太尼诱发咳嗽反应的预防效果。方法全麻患者150例，性别不限，年龄25～60岁，体重45～75kg，ASA分级I或Ⅱ级，采用随机数字表法，将其分为3组（n=50）：地佐辛组（Dez组）、羟考酮组（Oxy组）和生理盐水对照组（NS组）。Dez组静脉注射地佐辛0．1mg／kg（生理盐水稀释至10m1），5rain后静脉注射芬太尼3μg／kg，注射时间5s；Oxy组静脉注射羟考酮0．1mg／kg（用生理盐水稀释至10m1），5rain后静脉注射芬太尼3μg／kg，注射时间5s；NS组静脉注射生理盐水10ml，5min后静脉注射芬太尼3μg／kg，注射时间5s。记录芬太尼给药后2min内咳嗽反应的发生情况及程度。结果Oxy组、Dez组或NS组咳嗽反应的发生率分别为2％、4％或30％；与Ns组比较，Oxy组及Dez组咳嗽反应的发生率明显降低，且程度明显减轻（P〈0．01）；而Oxy组与Dez组比较其差异均无统计学意义（P〉0．05）。结论静脉注射羟考酮及地佐辛0．1mg／kg均可对芬太尼诱发的咳嗽反应产生显著的预防效果，且二者的效果相似。

Objective To compare oxycodone and dezocine for prevention of fentanyl-induced cough during induction of anesthesia. Methods One hundred fifty patients of both sexes, aged 25-60 yr, weighing 45 - 75 kg, of ASA physical status Ⅰ or Ⅱ , scheduled for elective surgery under general anesthesia, were randomly divided into 3 groups （ n = 50 each） using a random number table： dezocine group （group Dez）, oxyeodone group （group Oxy）, and normal saline control group （group NS）. In group Dez, dezocine 0.1 mg/kg （in 10 ml of normal saline） was injected intravenously, and 5 rain later fentanyl 3 txg/kg was injected over 5 s. In group Oxy, oxycodone 0.1 mg/kg （in 10 ml of normal saline） was injected intravenously, and 5 min later fentanyl 3 p.g/kg was injected over 5 s. In group NS, normal saline 10 ml was injected intravenously, and 5 min later fentanyl 3 p^g/kg was injected over 5 s. The occurrence and degree of cough were observed within 2 rain after administration of fentanyl. Results The incidence of cough was 2%, 4% and 30% in Oxy, Dez and NS groups, respectively. Compared with group NS, the incidence of cough was significantly decreased, and the degree of cough was mitigated in Oxy and Dez groups. There was no significant difference in the incidence and degree of cough between Dez group and Oxy group. Conclusion Both intravenous oxycodone and dezocine 0.1 mg/kg can significantly prevent fentanyl-induced cough during induction of anesthesia with similar efficacy.