地佐辛预防神经外科手术全麻诱导期芬太尼呛咳反应的临床观察

Clinical Observation of Dizocine in Preventing Fentanil-Induced Cough During Anesthesia Induction in Neurosurgery

目的 观察地佐辛对神经外科手术全麻诱导期芬太尼呛咳反应的预防作用.方法 将80 例择期神经外科全麻行气管插管的患者,随机分成对照组(C组,n=40)与地佐辛组(D组,n=40).于全麻诱导前5 min,C组静推生理盐水5 mL,D组静推地佐辛0.1 mg?kg-1,用生理盐水稀释至5 mL.记录C组、D组全麻诱导期间是否发生呛咳反应及其严重程度.在麻醉诱导前、气管插管前2 min、气管插管后2 min,记录C组和D组收缩压、舒张压、心率、脉氧饱和度.记录C组和D组全身麻醉诱导期间的不良事件,如呼吸抑制、心动过缓、血压异常、恶心呕吐等.结果 C组诱导期间9 例患者发生呛咳反应,呛咳发生率为22.5%;D组2 例发生呛咳反应,呛咳发生率为5.0%.与C组比较,D组全身麻醉诱导期间呛咳发生率显著下调(P<0.05).C组、D组全身麻醉诱导期间的不良反应发生率差异无统计学意义(P>0.05).结论 在神经外科手术的全麻诱导期,0.1 mg?kg-1地佐辛能有效缓解芬太尼的呛咳反应,而不增加不良事件的发生率.

Objective To observe the effect of dizocine in preventing fentanil-induced cough during anesthesia induction in neurosurgery. Methods 80 tracheal intubation patients under elective general anesthesia in neurosurgery were randomly divided into control group (group C, n=40) and dizocine group (group D, n=40). 5 minutes before induction of general anesthesia, patients in group C and group D separately received intravenously 5 mL normal saline and dezocine at 0.1 mg·kg-1. The incidence and severity of cough in patients were evaluated during anesthesia induction. Systolic blood pressure, diastolic blood pressure, heart rate (HR), and pulse oxygen saturation (SpO2) were recorded before anesthesia induction, 2 minutes before intubation and 2 minutes after intubation. Adverse events during anesthesia induction, such as respiratory depression, bradycardia, abnormal blood pressure, nausea and vomiting, were recorded. Results 9 patients in group C had cough and the incidence of cough was 22.5%. 2 patients in group D had cough and the incidence of cough was 5.0%. The occurrence of cough in group D was significantly lower than that in group C during anesthesia induction (P<0.05). There was no significant difference in the incidence of adverse events between group C and group D during anesthesia induction (P>0.05). Conclusion During anesthesia induction in neurosurgery, dizocine at 0.1 mg·kg-1 may effectively prevent fentanil-induced cough without increasing the incidence of adverse events.