盐酸戊乙奎醚联合深呼吸法对全麻诱导期芬太尼诱发咳嗽反应的影响

目的观察盐酸戊乙奎醚联合深呼吸法抑制麻醉诱导时芬太尼诱发的咳嗽反应(FIC)的有效性和安全性。方法选择行全身静脉麻醉的择期手术患者200例,随机分为四组,每组50例。H组在静脉推注芬太尼前,行深呼吸训练2次,做完深呼吸后立刻静注芬太尼;P组在静注芬太尼前10min静脉给予盐酸戊乙奎醚0.01mg/kg;HP组:在静注芬太尼前10min静脉给予盐酸戊乙奎醚0.01mg/kg,同时行深呼吸法训练,患者做完深呼吸后立即静注芬太尼;N组按一定的顺序进行静脉快速诱导。所有患者麻醉诱导时均推注芬太尼4μg/kg,时间5s。记录患者静注芬太尼后1min内咳嗽反应(FIC)发生率、咳嗽发生时间及严重程度。结果咳嗽发生率H组6例(12%)、P组5例(10%)、HP组2例(4%)、N组18例(36%),H组、P组、HP组咳嗽发生率明显低于N组(P0.05),四组咳嗽程度、咳嗽发生时间差异无统计学意义。四组术后恶心、呕吐、咳嗽、咳痰等不良反应差异无统计学意义。结论静注芬太尼前予以盐酸戊乙奎醚与深呼吸联合能有效抑制FIC的发生。

Effect of penehyclidine hydrochloride combining a huffing manoeuvre of fentanly on fentanly-induced cough

Objective To investigate the incidence of pre-induction coughing after intravenous fentanyl,and evaluate the therapeutic efficacy and safety of penehyclidine hydrochloride combining a huffing manoeuvre of fentanly induced cough.Methods Two hundred patients for elective operations were randomly allocated into four groups.Group H:patients were asked to perform huffing manoeu-vre just before the fentanyl injection by the anesthesiologist after demonstrating and guiding patients how to breath.Group P:patients were administered 0.01 mg/kg penehyclidine hydrochloride in 10 min just before the fentanyl injection.Group HP:patients were administered 0.01 mg/kg penehyclid-ine hydrochloride in 10 min and then the patients were asked to perform huffing manoeuvre just before the fentanyl injection by the anesthesiologist after demonstrating and guiding patients,breathing just before the fentanyl injection.group N:patients were given intravenous induction in a certain order. All groups received i.v.fentanyl (4 μg/kg)within 5 s.The incidence of fentany-induced cough (FIC) was recorded for 1 min before the induction of anaesthesia.Results The incidence of FIC was 6 (12%),5 (10%),2 (4%)and 18 (36%)in groups H,P,HP and N,Groups H,P and HP had a significantly lower incidence than that of group N (P < 0.05 ).However,there was no significant difference in the severity among the four groups.There were no significant differences among all the groups.Conclusion Pretreatment with penehyclidine hydrochloride combining a huffing manoeuvre of fentanyl induced cough could significantly reduced the incidence of cough caused by fentanyl injection.