地佐辛和布托啡诺对舒芬太尼诱导时呛咳作用的研究

Effect of dizocine and butorphanol on cough induced by sufentanil

目的观察静脉诱导前给予地佐辛、布托啡诺对全身麻醉患者舒芬太尼诱导时发生呛咳的影响。方法择期全身麻醉下行鼻内窥镜手术治疗患者90例,采用随机数字表法分为对照组、地佐辛组和布托啡诺组,每组30例。对照组诱导前10 min静脉注入生理盐水10 ml,地佐辛组诱导前10 min静脉注入0.1 mg/kg地佐辛,布托啡诺组诱导前10 min静脉注入1 mg布托啡诺。所有患者均采用丙泊酚2 mg/kg+舒芬太尼0.4μg/kg+顺式阿曲库铵20 mg静脉诱导,气管插管。术中均采用静吸复合麻醉维持,并根据血压、心率等参数调节吸入七氟醚的浓度。记录术中患者舒芬太尼诱导后发生呛咳反应的发生率和严重程度。结果 3组患者年龄、性别构成比、体质量比较差异无统计学意义(P> 0.05)。3组平均动脉压和心率比较差异无统计学意义(P> 0.05)。对照组有17例发生呛咳(5例为1级,12例为2级),地佐辛组1例发生呛咳为1级,布托啡诺组6例发生呛咳为1级。布托啡诺组、地佐辛组呛咳发生率明显少于对照组(P <0.05),且与布托啡诺组比较,地佐辛组呛咳发生率明显减少(P <0.05)。布托啡诺组和地佐辛组呛咳程度明显轻于对照组,差异有统计学意义(P <0.01)。与布托啡诺组比较,地佐辛组呛咳程度低,差异有统计学意义(P <0.01)。结论 0.1 mg/kg地佐辛和1 mg布托啡洛可以减轻舒芬太尼诱导的呛咳反应,地佐辛的抑制呛咳反应效果更佳。

Objective To investigate the effect of intravenous administration of dizocine and butophanol on cough induced by sufentanil in patients undergoing general anesthesia. Methods A total of 90 patients who were treated by endoscopic sinus surgery under elective general anesthesia were randomly divided into three groups: control group(group C), dizocine group(group D), and butophanol group(group B), with 30 cases in each group. Normal saline 10 ml, 0.1 mg/kg diazoxine diluted to 10 ml, and 1 mg butophanol diluted to 10 ml were intravenously given 10 min before induction in groups C, D, and B, respectively. Propofol 2 mg/kg + sufentanil 0.4 μg/kg + cis-atracurium 20 mg were intravenously given for induction and endotracheal intubation. Intravenous-inhalation combined anesthesia was used intraoperatively, and the concentration of sevoflurane inhalation was adjusted according to the parameters such as blood pressure and heart rate. The incidence and severity of cough reaction induced by sufentanil were recorded. Results There was no significant difference in age, sex ratio, body mass index, or operation time between the three groups(P > 0.05). There was also no significant difference in mean arterial pressure or heart rate between the three groups(P > 0.05). Seventeen patients in group C developed cough(5 grade 1 and 12 grade 2), and one patient in group D and six patients in group B had mild cough. The incidence of cough in groups B and D was significantly lower than that in group C(P < 0.01). Compared with group B, the incidence of cough in group D was significantly reduced(P < 0.01). The intensity of cough in groups D and B was significantly lower than that in group C(P < 0.01). Compared with group B, the intensity of cough was significantly lower in group D(P < 0.01). Conclusion Diazocine at 0.1 mg/kg and butophanol 1 mg can reduce the cough reaction induced by sufentanil, and dizocine has a better inhibitory effect on cough reaction.