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| 纳美芬预防全麻诱导时舒芬太尼诱发呛咳的临床效果 |
| Effect of nalmefene on sufentanil-induced cough during induction of general anesthesia |
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| DOI：10.12089/jca.2018.08.003 |
| 中文关键词: 舒芬太尼 纳美芬 呛咳 |
| 英文关键词: Sufentanil Nalmefene Cough |
| 基金项目:国家自然科学基金(81471852) |
| 作者 | 单位 | E-mail | | 杜春春 | 200032,上海市,复旦大学附属肿瘤医院麻醉科,复旦大学上海医学院肿瘤学系 | | | 孙志荣 | 200032,上海市,复旦大学附属肿瘤医院麻醉科,复旦大学上海医学院肿瘤学系 | | | 徐亚军 | 200032,上海市,复旦大学附属肿瘤医院麻醉科,复旦大学上海医学院肿瘤学系 | | | 薛萍 | 200032,上海市,复旦大学附属肿瘤医院麻醉科,复旦大学上海医学院肿瘤学系 | | | 钟静 | 200032,上海市,复旦大学附属肿瘤医院麻醉科,复旦大学上海医学院肿瘤学系 | | | 许平波 | 200032,上海市,复旦大学附属肿瘤医院麻醉科,复旦大学上海医学院肿瘤学系 | xupingboshanghai@163.com |
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| 中文摘要: |
目的 观察纳美芬对全麻诱导时舒芬太尼诱发呛咳、术中丙泊酚用量以及术后镇痛效果的影响。
方法 选取拟行乳腺癌根治术的全麻患者300例,年龄18～60岁,BMI 18～30 kg/m2，ASA Ⅰ—Ⅲ级,根据随机数字表法将患者随机分为4组,每组75例:C组(生理盐水)、L组(利多卡因1 mg/kg),N1组(纳美芬0.1 μg/kg)和N2组(纳美芬0.2 μg/kg)。各组分别给予相应的药物2 min后开始全麻诱导:靶控输注丙泊酚3.5 μg/ml、静推舒芬太尼0.3 μg/kg(时间5 s)2 min后,静推罗库溴铵0.6 mg/kg,90 s后插管。术毕静注氟比洛芬酯50 mg镇痛。记录呛咳发生率及严重程度,记录术中丙泊酚用量,记录术毕、术后6 h及24 h的VAS疼痛评分。
结果 C、L、N1及N2组患者呛咳发生率分别为37.3%、21.3%、5.3%及1.3%。N1组和N2组呛咳发生率明显低于C组和L组(P<0.01或P<0.05),N1组和N2组差异无统计学意义。C、L组术中丙泊酚用量明显少于N2组(P<0.05)。四组术后VAS疼痛评分差异无统计学意义。
结论 纳美芬0.1 μg/kg可有效预防全麻诱导时舒芬太尼引起的呛咳,且不影响术中丙泊酚用量及术后的镇痛效果。 |
| 英文摘要: |
Objective To observe the effect of nalmefene on preventing sufentanil-induced cough during induction of general anesthesia, and its effect on the intraoperative propofoldosage and postoperative analgesia.
Methods A total of 300 breast cancer patients undergoing radical mastectomy under general anesthesia, aged 18 - 60 years, BMI 18 - 30 kg/m2, ASA physical status Ⅰ-Ⅲ, were randomly divided into 4 groups (n = 75): group C (physiological saline), group L (lidocaine 1 mg/kg), group N1 (nalmefene 0.1 μg/kg) and group N2 (nalmefene 0.2 μg/kg). Two minites after giving the corresponding drug for each group, general anesthesia was induced according to the following: TCI propofol (3.5 μg/ml) and intravenous injection of 0.3 μg/kg sufentanil within 5 seconds, 0.6 mg/kg rocuronium was intravenously injected, 90 seconds later, intubation was performed. The incidence and severity of cough and intraoperative dosage of propofol were recorded. The pain VAS scores at 0 h, 6 h and 24 h after operation were recorded.
Results The incidence of cough in groups C, L, N1 and N2 was 37.3%, 21.3%, 5.3% and 1.3%, respectively. The incidence of cough in group N1 was significantly lower than that of group C and group L (P < 0.01 or P < 0.05). There was no difference in preventing sufentanil-induced cough between group N1 and group N2. Compared with groups C and L, the intraoperative dosage of propofol was greater in group N2 (P < 0.05). There was no difference in postoperative pain VAS scores between the four groups.
Conclusion Nalmefene 0.1 μg/kg can prevent sufentanil-induced cough during induction without affecting intraoperative propofol dosage and postoperative analgesia. |
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