芬太尼不同给药速度对诱发咳嗽反应的影响

目的观察麻醉诱导时不同给药速度输注芬太尼对诱发咳嗽反应(fentanyl cough reflx,FCR)的影响,选择最佳的给药速度。方法选择择期手术60例全麻患者随机分成3组:Ⅰ组30 s内经静脉直接注射芬太尼4μg/kg;Ⅱ组以120滴的滴速滴入芬太尼4μg/kg;Ⅲ组以60滴的滴速滴入芬太尼4μg/kg;记录患者是否发生咳嗽及呛咳的程度。并同时记录芬太尼注射前、后的血压、心率、呼吸和脉搏血氧饱和度,以及药物不良反应。结果Ⅰ组患者FCR发生率为75%,Ⅱ组为5%,三组为0,且Ⅰ组的呛咳程度显著高于Ⅱ组(P<0.01)。Ⅰ组在给药后多伴有心率增快、血压增加,与其他两组比较有显著性差异(P<0.05)。结论经外周静脉30 s秒内直接注射芬太尼4μg/kg时FCR的发生率高,120滴及60滴侧管滴注芬太尼明显降低患者咳嗽的发生率或不发生,提高了麻醉的安全性。

Fentanyl the Influence of Different Dosing Speed Response to Induce Cough

Objective To observe anesthesia induced different dosing speed infusion of fentanyl induced cough response （fentanyl cough reflx, FCR）, the influence of selecting the best drug delivery speed. Methods 60 patients with general anesthesia were randomLy divided into 3 groups elective surgical procedures：Ⅰgroup 30 seconds canon vein injected fentanyl （including 4 μg/kg;Ⅱgroup in 120 the drop drops into fentanyl （including 4 μg/kg）;Ⅲgroup to 60 of the dripping speed drops into the fentanyl （including 4 μg/kg）;record whether patients with the extent of the coughing and choking. And at the same time record of fentanyl injection before and after the blood pressure, heart rate, breathing and pulse oxygen saturation, and adverse drug reactions. Results Ⅰgroup patients was 75%, incidence of FCRⅡgroup was 5%, the three groups of 0, and the degree of choking coughⅠgroup is significantly higher thanⅡgroup （P＆lt;0.01）.Ⅰgroup after dosing more associated with an increase in heart rate increase fast, blood pressure, compared with the other two groups had significant difference （P＆lt;0.05）. Conclusion Via peripheral vein within 30 seconds of direct injection of fentanyl （including 4 μg/kg）, high incidence of FCR, 120 and 60 drops drip fentanyl side tube significantly reduce the incidence of patients with cough or doesn＆#39;t happen, to improve the safety of anesthesia.