芬太尼分次注射对其诱发呛咳反应的临床观察

目的观察芬太尼分次注射对其诱发的咳嗽反射的影响。方法选择400例全身麻醉的患者，随机分为4组，A组预先注入0．9％生理盐水5mL，1min后注入2．5μg/kg芬太尼；B组预先注入0．5μg/kg芬太尼，1min后注入2μg/kg芬太尼；C组预先注入1μg/kg芬太尼，lmin后注入1．5μg/kg芬太尼；D组预先注入1．5μg/kg芬太尼，1min后注入1μg/kg芬太尼。观察各组呛咳反应的发生率。结果四组咳嗽的发生率分男11为68％、5％、40％、64％，B组和C组显著低于A组和D组（P〈0．05），B组显著低于C组（P〈0．05）。结论预先注入0，5μg/kg芬太尼，1min后注入2μg/kg芬太尼，这种分次注药方式可以降低全麻诱导期间咳嗽的发生率。

Effects of Different Priming Doses of Fentanyl on Fentanyl-induced Cough

Objective To observe the effects of different priming doses of fentanyl on fentanyl - induced cough during anesthesia induction. Methods Four hundred patients were randomized into 4 groups （ n = 100） to receive the intravenous injection of sodium chloride （group A） , fentanyl 0. 5 μg/kg （group B） , fentanyl 1 μg/kg （group C） , and fentanyl 1.5μg/kg （ group D） one minute before a bolus of fentanyl 2. 5 μg/kg, 2μg/kg, l. 5μg/kg or 1 μg/kg respectively. The occurrence and severity of cough were recorded for 2 minutes after fentanyl bolus. Results The incidence of fentanyl - induced cough was 68% in group A, 5% in group B, 40% in group C, and 64% in group D, respectively. Groups B and C had a lower incidence and less severity of cough than group A and D （ P 〈 0. 05 ）. Groups B had a lower incidence and less severity of cough than group C （ P 〈 0. 05 ）. Conclusion A priming dose of 0. 5μg/kg of fentanyl is effective to suppress fentanyl - induced cough in a dose dependent manner. We suggest using a priming dose of fentanyl 0. 5μg/kg to suppress cough during the anesthesia induction in clinical practice.