预先静脉注射盐酸纳布啡对舒芬太尼呛咳反应的抑制作用

The Inhibitory Effect of Preintravenous Injection of Nalbuphine Hydrochloride on Cough Reaction Induced by Sufentanil

目的:观察预先静脉注射盐酸纳布啡对气管插管全麻诱导过程中舒芬太尼诱发呛咳反应的抑制作用。方法:选择我院2017年8月至2018年2月ASAⅠ～Ⅱ级、择期全麻手术患者100例,随机分为纳布啡组和对照组,每组50例。麻醉诱导前15min纳布啡组静注0.1mg/kg纳布啡(用生理盐水稀释至1mg/mL),对照组静注等容量生理盐水(0.9%生理盐水)。麻醉诱导过程中,所有患者均静脉注射舒芬太尼1μg/kg,注药时间控制在10s内。注射结束后2min,记录各组患者发生呛咳的时间和次数。2min后两组依次静脉注射咪哒唑仑0.06mg/kg,依托咪酯0.3mg/kg和罗库溴铵0.8mg/kg,5min后进行气管插管。结果:两组比较,纳布啡组呛咳反应发生率明显低于对照组,且呛咳反应发生时间稍晚于对照组,差异均有统计学意义(均P<0.05)。结论:气管插管全麻诱导前经静脉给予纳布啡0.1mg/kg,可有效降低舒芬太尼诱导的呛咳反应。

Objective:To observe the inhibitory effect of preintravenous injection of nalbuphine hydrochloride on cough induced by sufentanil in general anesthesia induction during endotracheal intubation.Methods:A total of 100 cases from level of I to II in ASA classification undergoing elective general anesthesia operation were randomly divided into nalbuphine group and control group,with 50 cases in each group,respectively.Nalbuphine at a dose of 0.1 mg/kg(diluted with normal saline to 1 mg/mL)or equal volume of normal saline were injected through peripheral vein at 15 min before anesthesia induction.Sufentanil was used to induce anesthesia at a dose of 1μg/kg,via intravenous injection within 10 s.The occurrence and frequency of cough were begun to record at 2 min after sufentanil infusion.And then,each case was intravenously suffered with midazolam at a dose of 0.06 mg/kg,etomidate at a dose of 0.3 mg/kg and rocuronium at a dose of 0.8 mg/kg after 2 min.Finally,the endotracheal intubation was conducted in the next 5 min.Results:The incidence of cough was significantly lower and the cough onset time was slightly later in nalbuphine group,when compared to the control group(All P<0.05).Conclusion:Preintravenous injection of nalbuphine at a dose of 0.1 mg/kg could effectively reduce the incidence of irritating cough caused by sufentanil in general anesthesia induction during endotracheal intubation.