小剂量舒芬太尼预处理对依托咪酯和舒芬太尼全麻诱导期咳嗽肌颤的抑制作用研究

Study of the Inhibitory Effect of Small-dose Sufentanil Preconditioning on Cough Myofibrillation during Induction of General Anesthesia with Etomidate and Sufentanil

目的:评价小剂量舒芬太尼预处理对依托咪酯和舒芬太尼全麻诱导期咳嗽和肌颤的抑制作用,为临床应用提供参考。方法:选取2020年9月1日—2020年10月31日在福建省肿瘤医院接受全麻气管插管100例择期手术的患者作为研究对象,最终纳入86例患者,排除14例患者。采用随机数表法将其分为治疗组(n=44)和对照组(n=42)。全麻诱导前治疗组5 s内静脉注射舒芬太尼0.1μg/kg(稀释至2 mL);对照组5 s内给予生理盐水2 mL。注射1 min后两组患者均给予舒芬太尼0.5μg/kg进行全身麻醉诱导,5 s内注射完成,1 min后给予依托咪酯0.3 mg/kg和顺式阿曲库铵0.15 mg/kg。记录依托咪酯给药后1 min内咳嗽和肌颤的发生率及严重程度,以及舒芬太尼预给药即刻(T0)、给药后3 min(T1)、插管后1 min(T2)、插管后3 min(T3)的平均动脉压(MAP)和心率(HR)。结果:对照组患者咳嗽的发生率和严重程度均高于治疗组,差异有统计学意义(P<0.05)。对照组患者肌颤的发生率和严重程度均高于治疗组,差异有统计学意义(P<0.05)。两组患者均未出现呼吸抑制等相关并发症。结论:小剂量舒芬太尼预处理能降低依托咪酯和舒芬太尼全麻诱导期咳嗽和肌颤的发生率和严重程度。

Objective:To evaluate the inhibitory effect of small-dose sufentanil pretreatment on cough and myofibrillation during the induction period of general anesthesia with etomidate and sufentanil for clinical application.Methods:100 patients who underwent elective surgery with general anesthesia tracheal intubation in the hospital from September 1,2020 to October 31,2020 were selected for the study.86 patients were finally included and 14 were excluded.They were divided into the treatment group(n=44)and the control group(n=42)using the random number table method.Before the induction of general anesthesia,sufentanil 0.1μg/kg(diluted to 2 mL)was injected intravenously within 5 s in the treatment group,and saline 2 mL was given within 5 s in the control group.General anesthesia was induced by sufentanil 0.5μg/kg in both groups 1 min after injection,which was completed within 5 s.Etomidate 0.3 mg/kg and cisatracurium 0.15 mg/kg were given 1 min later.The incidence and severity of cough and myofibrillation within 1 min after etomidate administration,as well as mean arterial pressure(MAP)and heart rate(HR)at the immediate moment of sufentanil preadministration(T0),3 min after administration(T1),1 min after intubation(T2),and 3 min after intubation(T3)were recorded.Results:The incidence and severity of cough in the control group were higher than those in the treatment group,and the difference was statistically significant(P<0.05).The incidence and severity of myofibrillation in patients in the control group were higher than those in the treatment group,and the difference was statistically significant(P<0.05).There were no complications related to respiratory depression in either group.Conclusion:Low-dose sufentanil preconditioning reduces the incidence and severity of cough and myofibrillation during induction of general anesthesia with etomidate and sufentanil.