盐酸羟考酮与地佐辛抑制芬太尼诱发全身麻醉诱导期呛咳反应效果的比较

Comparison of oxycodone hydrochloride versus dizocine for suppression of fentanylinduced coughing during induction of general anesthesia

目的 比较盐酸羟考酮与地佐辛抑制芬太尼诱发全身麻醉诱导期呛咳反应的效果。方法 择期静脉全身麻醉下妇科手术患者180例,ASAⅠ或Ⅱ级,年龄18-45岁,采用随机数字表法,将患者随机分为3组（均n=60）：羟考酮组（O组）、地佐辛组（D组）和对照组（N组）。O组、D组和N组分别静脉注射等容量盐酸羟考酮注射液0.1mg/kg、地佐辛注射液0.1mg/kg、生理盐水,O组给药后5分钟、D组给药后2分钟时静脉注射芬太尼,注射时间均5秒,2分钟后给予其他诱导药物,观察芬太尼注射后2分钟内患者呛咳的发生情况和程度。记录观察期内不良事件的情况。结果 与N组比较,O与D两组患者呛咳发生率及严重程度显著降低（P〈0.05）;与O组比较,D组呛咳发生率及轻度呛咳反应明显降低（P〈0.05）,但两组中、重度呛咳反应未见明显差别（P〉0.05）。结论 麻醉诱导前静脉注射地佐辛0.1mg/kg抑制芬太尼诱发全身麻醉诱导期呛咳反应的效果优于盐酸羟考酮0.1mg/kg。

Objective To compare oxycodone hydrochloride versus dizocine for suppression of fentanyl-induced coughing during induction of general anesthesia in adult patients. Method One hundred and eighty ASA physical status Ⅰ or Ⅱ patients,aged 18 45 yr, undergoing elective gynecological operations under total intravenous anesthesia,were randomized into 3 groups（n=60 each）： oxycodone hydrochloride group（group O）, dizocine group（group D） and control group（groupN）. In group O, group D and group N, oxycodone hydrochloride and dizocine at 0.1mg/kg（in 5ml normal saline）were injected, respectively, equal saline solution N group was also injected;fentanyl was injected in group O 5 min later while it was injected in group D 2 min later. Both groups received the injection intravenously for 5s, and 2min later other drugs for induction of anesthesia were given. The development and intensity of cough were observed within 2min after fentanyl injection.The occurrence of adverse events was recorded. Result Compared with group N,the incidence and degree of coughing was significantly reduced in group D and group O （P 〈 0.05）.The incidence of cough and mild cough reflex was significantly lower in group D than that in group O（P〈0.05）, but there was no significant difference between both groups in the incidence of moderate and severe coughing （P〈0.05） Conclusion Injection of Dizocine at 0.1mg/kg before induction of anesthesia has better suppressive effect on fentanyl cough reflex during induction of general anesthesia than injectionof oxycodone hydrochloride at 0.1mg/kg.