羟考酮预防芬太尼诱发咳嗽反应的价值研究

Value of Oxycodone in prevention of Fentanyl-induced cough

目的探讨羟考酮对芬太尼诱发咳嗽反应的预防价值。方法选取2013年1月-2015年11月该院行全身麻醉下择期手术的186例患者为研究对象,采用随机数字表法分为羟考酮组、右美托咪定组及对照组3组,每组62例。羟考酮组患者给予羟考酮0.1 mg/kg静脉注射;右美托咪定组患者给予右美托咪定1μg/kg静脉注射;对照组患者给予生理盐水10ml静脉注射。所有患者5 min后静脉注射芬太尼3μg/kg,3~5 s内注射完毕,2 min后再给予其他麻醉诱导药物。比较3组的术前基线资料及咳嗽反应发生状况。结果 3组的术前基线资料比较,差异无统计学意义(P>0.05),具有可比性。羟考酮组、右美托咪定组、对照组的咳嗽反应发生率分别为3.2%(2/62)、12.9%(8/62)和27.4%(17/62),经χ~2检验,差异有统计学意义(P<0.05),羟考酮组的发生率低于右美托咪定组和对照组。羟考酮组和右美托咪定组的咳嗽反应严重程度轻于对照组,差异有统计学意义(P<0.05),而羟考酮组与右美托咪定组的咳嗽反应严重程度比较,差异无统计学意义(P>0.05)。结论应用芬太尼麻醉诱导前静脉注射0.1 mg/kg羟考酮能降低咳嗽反应的发生率和严重程度,预防效果优于右美托咪定,值得临床推广应用。

Objective To investigate the value of Oxycodone in prevention of Fentanyl-induced cough. Methods In this study, 186 patients undergoing elective surgery under general anesthesia in our hospital from January 2013 to November 2015 were enrolled and randomly divided into Oxycodone group, Dexmedetomidine group and control group, each group had 62 cases. The patients in the Oxycodone group were given Oxy-codone 0.1 mg/kg by intravenous injection; the patients in the Dexmedetomidine group were given Dexmedeto-midine 1μg/kg by intravenous injection; and the patients in the control group were given normal saline 10 ml by intravenous injection. In 5 min after that, all the cases were given Fentanyl 3μg/kg by intravenous injection within 3-5 s, 2 min after they were given other anesthesia induction drugs. The preoperative baseline data and incidence of cough were compared among the three groups. Results There were no significant differences in the preoperative baseline data among the 3 groups （P〉0.05）, so they had comparability. The incidence of cough response in the Oxycodone group, the Dexmedetomidine group and the control group was 3.2% （2/62）, 12.9% （8/62） and 27.4% （17/62） respectively, there were statistically significant differences among them （P〈0.05）, and the incidence in the Oxycodone group was significantly lower than that in the Dexmedetomidine group and the control group （P〈0.05）. The cough response in the Oxycodone group and the Dexmedetomidine group was significantly milder than that in the control group （P〈0.05）, and there was no significant difference between the Oxycodone group and the Dexmedetomidine group （P〉0.05）. Conclusions Intravenous injection of Oxycodone 0.1 mg/kg could significantly reduce the incidence and severity of Fentanyl-induced cough, and its preventive effect is better than that of Dexmedetomidine. It is worthy of clinical popularization and application.