咪达唑仑致浅镇静状态对芬太尼诱发呛咳的影响

Effect of light sedation induced by midazolam on cough induced by fentanyl

目的:探讨小剂量咪达唑仑致浅镇静状态对芬太尼诱发呛咳的影响。方法:择期全麻手术患者60例,采用随机数字表法分为对照组和咪唑组,各30例。咪唑组予以咪达唑仑0.03 mg/kg(1 mg/m L),对照组予以等量0.9%氯化钠注射液。3 s内匀速静脉推注,120 s 2组均后予芬太尼3μg/kg(50μg/m L),3 s内匀速静脉推注。观察并记录给药后120 s呛咳的发生率和程度、静脉推注芬太尼时的麻醉/意识深度值及改良OAA/S评分。结果:与对照组比较,咪唑组患者的呛咳发生率明显增高(P<0.01),呛咳程度显著加重(P<0.01);麻醉/意识深度值较对照组明显降低(P<0.01),为浅镇静状态。静脉推注芬太尼时咪唑组的改良OAA/S评分均≥4分。结论:小剂量的咪达唑仑致浅镇静状态时,静脉推注芬太尼诱发的呛咳发生率增加、呛咳的程度加重。

Objective： To investigate the effects of the light sedation induced by low dose midazolam on cough induced by fentanyl.Methods： Sixty patients scheduled by general anesthesia operation were divided into the control group and midazolam group using a random number table（ 30 cases each group）. The midazolam group were intravenously injected with 0. 03 mg / kg（ 1 mg / m L） of midazolam. The control group were intravenously injected with equal amount of 0. 9% sodium chloride injection for 3 s,and the 3 μg / kg（ 50 μg/m L） of fentanyl was used for 3 s after 120 s. The occurrence rate and degree of cough,the anesthesia/awareness depth and modified OAA / S score at the time of using fentanyl were recorded after 120 s of treatment. Results： Compared with the control group,the incidence and severity of cough significantly increased in midazolam group（ P〈0. 01）,the value of the depth of anesthesia /consciousness significantly decreased in midazolam group,which arrived at light sedation（ P〈0. 01）. The score of modified OAA / S in midazolam group was more than or equal to 4 points after the intravenous injection of fentanyl. Conclusions： At the time of light sedation induced by a low dose of midazolam,the incidence and severity of cough caused by intravenous injection fentanyl increase.