不同给药顺序对舒芬太尼麻醉诱导时呛咳的影响

目的:观察不同给药顺序对舒芬太尼麻醉诱导诱发呛咳的影响。方法:选择90例的择期全麻患者,年龄19～61岁,随机分为3组(A、B、C组),每组30例。麻醉诱导顺序:A组:丙泊酚-舒芬太尼-顺式阿曲库铵;B组:丙泊酚-顺式阿曲库铵(总量1/4)-舒芬太尼-顺式阿曲库铵(总量3/4);C组:丙泊酚-顺式阿曲库铵-舒芬太尼。诱导用药:丙泊酚:2.0mg.kg-1(15 s),舒芬太尼0.6μg.kg-1(10 s),顺式阿曲库铵:0.15 mg.kg-1(5 s)。观察各组给药后呛咳发生的例数及呛咳时血流动力学变化。结果:A组出现呛咳10例(33.3%),B组出现呛咳4例(13.3%),C组出现呛咳1例(3.3%)。A组与B、C组呛咳发生率有显著性差异(P<0.05),B组与C组间呛咳发生有显著性差异(P<0.05)。呛咳可引起血压明显升高、心率显著加快。结论:采用丙泊酚-顺式阿曲库铵-舒芬太尼的静脉诱导给药顺序,预先给予肌松药,不需额外用药,能显著减少舒芬太尼诱发呛咳反应的发生。

Effect of different administration sequence on sufentanyl-induced cough response during anesthesia induction

OBJECTIVE To investigate the effectiveness of different administration sequence in suppressing sufentanyl-induced cough response during anesthesia induction.METHODS Ninety ASAⅠ-Ⅱselected general anesthesia patients were randomly assigned into three groups with thirty patients each group.Anesthesia induction sequence :Group A:propofol-sufentanyl-atracurium,Group B: propofol atracurium(quarter of total dosage)-sufentanyl,Group C: propofol atracurium-sufentanyl.Patients received propofol 2.0 mg·kg-1,sufentanyl 0.6 μg·kg-1 and atracurium 0.15 mg·kg-1 for anesthesia induction.The occurrence of cough and cough-induced haemodynamics change were observed.RESULTS The patient with coughing was ten in group A,four in group B and one in group C.The occurrence of cough was significantcy higher in group A than those in group B and group C,while there was no difference between group B and group C.Coughing could induce blood pressure and heart rate to heighten significanty.CONCLUSION Administration sequence of propofol atracurium-sufentanyl during anesthesia induction can significantly attenuate sufentanyl-induced cough response.