盐酸纳美芬预防全麻诱导时舒芬太尼诱发咳嗽的效果

Efficacy of nalmefene in preventing sufentanil-induced cough during induction of general anesthesia

目的 评价盐酸纳美芬对全麻诱导时舒芬太尼诱发咳嗽的预防效果.方法 择期全麻下行腹腔镜胆囊切除术患者100例,年龄21～ 62岁,体重45～ 82 kg,性别不限,ASA分级Ⅰ或Ⅱ级,采用随机数字表法分为2组（n=50）：盐酸纳美芬组（N组）和对照组（C组）.N组于麻醉诱导前2min静脉注射盐酸纳美芬0.25 μg/kg,C组静脉注射等容量生理盐水.全麻诱导：采用靶控输注丙泊酚,BIS值达55时,静脉注射舒芬太尼0.5 μg/kg,注射时间5 s,观察静脉注射舒芬太尼后2 min内发生咳嗽的例数及程度,观察结束后使用其他静脉麻醉药物诱导.结果 N组咳嗽发生率为8％,C组为48％.与C组比较,N组咳嗽发生率及严重程度明显降低（P＜0.05）.结论 麻醉诱导前2 min静脉注射盐酸纳美芬0.25 μg/kg可有效降低全麻诱导时舒芬太尼诱发咳嗽的发生率.

Objective To evaluate the efficacy of nalmefene in preventing sufentanil-induced cough during induction of general anesthesia.Methods One hundred American Society of Anesthesiologists physical status Ⅰ orⅡ patients of both sexes,aged 21-62 yr,weighing 45-82 kg,undergoing elective laparoscopic cholecystectomy under general anesthesia,were divided into 2 groups （n =50 each） using a random number table：nalmefene group （group N） and control group （group C）.Nalmefene 0.25 μg/kg was injected intravenously at 2 min before anesthesia induction in group N,and the equal volume of normal saline was given instead in group C.Anesthesia was induced with target-controlled infusion of propofol,and sufentanil 0.5 μg/kg was injected over 5 s when bispectral index value reached 55.The number of patients who developed cough within 2 min after sufentanil injection and severity of cough were observed.Other iv anesthetics were given for induction after the end of observation.Results The incidence of sufentanil-induced cough was 8% in group N and 48% in group C.Compared with group C,the incidence and severity of cough were significantly decreased in group N （P〈0.05）.Conclusion Nalmefene 0.25 μg/kg injected at 2 min before induction of anesthesia can effectively decrease the development of sufentanil-induced cough during induction of general anesthesia.