咪达唑仑致浅镇静状态对芬太尼诱发呛咳的影响

目的:探讨小剂量咪达唑仑致浅镇静状态对芬太尼诱发呛咳的影响。方法:择期全麻手术患者60例，采用随机数字表法分为对照组和咪唑组，各30例。咪唑组予以咪达唑仑0.03 mg/kg（1 mg/mL），对照组予以等量0.9%氯化钠注射液。3 s内匀速静脉推注，120 s 2组均后予芬太尼3 μg/kg（50 μg/mL），3 s内匀速静脉推注。观察并记录给药后120 s呛咳的发生率和程度、静脉推注芬太尼时的麻醉/意识深度值及改良OAA/S评分。结果:与对照组比较，咪唑组患者的呛咳发生率明显增高（P<0.01），呛咳程度显著加重（P<0.01）；麻醉/意识深度值较对照组明显降低（P<0.01），为浅镇静状态。静脉推注芬太尼时咪唑组的改良OAA/S评分均≥4分。结论:小剂量的咪达唑仑致浅镇静状态时，静脉推注芬太尼诱发的呛咳发生率增加、呛咳的程度加重。

Effect of light sedation induced by midazolam on cough induced by fentanyl

Objective:To investigate the effects of the light sedation induced by low dose midazolam on cough induced by fentanyl. Methods:Sixty patients scheduled by general anesthesia operation were divided into the control group and midazolam group using a random number table(30 cases each group). The midazolam group were intravenously injected with 0. 03 mg/kg(1 mg/mL) of midazolam. The control group were intravenously injected with equal amount of 0. 9% sodium chloride injection for 3 s,and the 3μg/kg (50 μg/mL) of fentanyl was used for 3 s after 120 s. The occurrence rate and degree of cough,the anesthesia/awareness depth and modified OAA/S score at the time of using fentanyl were recorded after 120 s of treatment. Results:Compared with the control group, the incidence and severity of cough significantly increased in midazolam group(P <0. 01),the value of the depth of anesthesia/consciousness significantly decreased in midazolam group,which arrived at light sedation(P<0. 01). The score of modified OAA/S in midazolam group was more than or equal to 4 points after the intravenous injection of fentanyl. Conclusions:At the time of light sedation induced by a low dose of midazolam,the incidence and severity of cough caused by intravenous injection fentanyl increase.