不同剂量地佐辛抑制舒芬太尼呛咳反应的临床观察

目的 观察不同剂量地佐辛对全麻诱导期舒芬太尼诱发呛咳反应的影响.方法 择期选择全麻手术患者60例,ASA Ⅰ或Ⅱ级,随机分为3组(n=20),分别于麻醉诱导前静注地佐辛0.05mg/kg (D1组)、0.1mg/kg (D2组)、0.15mg/kg(D3组),10min后3组患者均在3s内快速静注舒芬太尼0.4μg/kg,1min后行麻醉诱导.记录舒芬太尼注射后1min内发生呛咳反应的例数和强度.记录地佐辛静注前(T0)、地佐辛静注后10min (T1)、舒芬太尼静注后1min(T2)时的心率(HR)、平均动脉压(MAP)、脉搏氧饱和度(SpO2)和镇静评分(OAA/S).结果 3组患者舒芬太尼静注后1min内均未发生呛咳反应.与T0时比较,T1、T2时D3组HR、MAP、Sp02及OAA/S评分均降低(P＜0.05);与D1、D2组比较,D3组T1、T2时MAP、SpO2及OAA/S评分降低,T2时HR降低,差异有统计学意义(P＜0.05).结论 全麻诱导前静脉注射地佐辛0.05mg/kg、0.1 mg/kg、0.15mg/kg均可有效抑制舒芬太尼诱发的呛咳反应,以0.05mg/kg、0.1mg/kg应用较为安全.

Clinical observation on different doses of dezocine to inhibit sufentanil-induced cough during general anesthesia induction

Objective To observe the effects of different doses of dezocine on sufentanil-induced cough during general anesthesia induction. Methods 60 patients of ASA I or II underwent general anesthesia were randomly allocated into three groups of D1, D2 and D3 with 20 patients in each group. Three groups received intravenous injection with different doses of dezocine O.05mg/kg（group D1）, O.lmg/kg（group D2） and 0.15mg/kg（group D3） before general anesthesia induction. After 10minutes, all patients were injected with sufentanil （0.4μg/kg） through peripheral venous within 3 seconds, then three groups were induced lmin later. The occurrence of cough reflex and degree of cough were recorded in lmin after sufentanil injection. Heart rate（HR）, mean arterial pressure（MAP）, SpO2 and the degree of OAA/S were recorded before the administration of dezocine （T0）, lOmin after intravenous dezocine （T1） and lmin after sufentanil injection （T2）. Results No patient had cough in three groups. Compared with To, HR, MAP, SpO2 and the degree of OAA/S at T1 and T2 were significantly lower in group D3（P〈0.05）. Compared with group D1 and D2, MAP, SpO2 and the degree of OAA/S at T1 and T2 were significantly lower in group D3, HR was significantly lower in group D3 at T2 （P〈0.05）. Conclusion Intravenous dezocine with 0.05mg/kg, 0.1mg/kg or 0.15mg/kg can suppress sufentanil-induced cough effectively before general anesthesia induction, and intravenous dezocine with 0.05mg/kg and 0.1mg/kg can safely suppress the sufentanil-induced cough.