不同给药顺序对芬太尼呛咳反应的影响

目的探讨全麻诱导时不同给药顺序对芬太尼呛咳反应的影响。方法选择80例ASAⅠ-Ⅱ择期行全麻手术的患者,随机分为四组。Ⅰ组诱导采用芬太尼4μg/kg、咪唑安定0.05mg/kg、丙泊芬1.5mg/kg、维库溴铵0.15mg/kg;Ⅱ组诱导采用咪唑安定0.05mg/kg、芬太尼4μg/kg、丙泊芬1.5mg/kg、维库溴铵0.15mg/kg;Ⅲ组诱导采用咪唑安定0.05mg/kg、丙泊芬1.5mg/kg、芬太尼4μg/kg、维库溴铵0.15mg/kg;Ⅳ组诱导采用咪唑安定0.05mg/kg、丙泊芬1.5mg/kg、维库溴铵0.15mg/kg、芬太尼4μg/kg。观察各组呛咳发生率和诱导前后血流动力学的变化。结果与Ⅳ组相比,Ⅲ组呛咳发生率有明显差异（P〈0.05）。与Ⅳ组相比,Ⅰ组、Ⅱ组呛咳发生率有特别明显差异（P〈0.01）。结论全麻诱导期,按顺序静注咪唑安定、丙泊芬、维库溴铵、芬太尼,可有效消除芬太尼诱发的呛咳反应。

Different order of administration of fentanyl choking reaction.

Objective To investigate the induction of general anesthesia is different from the order of administration of fentanyI choking reaction. Methods to choose 80 cases of ASAⅠ - Ⅱ selective surgery in patients with general anesthesia were randomly divided into four groups. Group I induced using fentanyl 4 μ g / kg, midazolam 0.05 mg/ kg, propofol 1.5-fen mg/ kg, vecuroinurn 0.15 mg / kg, H group induced by the use of midazolarn 0.05 mg / kg, fentanyl 4mg / kg, propofol 1.5-fen mg / kg, vecurodium 0.15 mg / kg, Ⅲ group induced by the use of midazolam 0.05 mg/ kg, propofol 1.5-fen mg / kg, fun Nepal too 4 μ g / kg, vecuronium 0.15 mg / kg, Ⅳ group induced by the use of midazolarn 0.05 mg/ kg, propofol 1.5-fen mg / kg, vecuronium 0. 15 mg / kg, fun Nepal too 4 μ g / kg. Observed in each group and the incidence of cough-induced hemodynarnic changes before and after. Results compared with group Ⅳ, Ⅲ Group choking have significant differences in the incidence （P 〈0.05）. Compared with group Ⅳ, Ⅰ group, Ⅱ group the incidence of cough in particular have significant differences （P 〈0.01）. Conclusion general anesthesia induction period, according to the order of intravenous midazolam, propofol-fen, vecuroniurn, fentanyl, which can effectively eliminate the fentanyl-induced cough response.