预注维库溴铵对芬太尼诱发咳嗽的影响  

Intravenous Vecuronium Pretreatment Reduces Fentanyl-induced Cough

作　　者：张志永[1] 马璐璐[1] 薛杨[1] 卢素芳[1] 黄宇光[1] 

机构地区：[1]中国医学科学院 北京协和医学院 北京协和医院麻醉科,北京100730

出　　处：《协和医学杂志》2012年第4期427-429,共3页Medical Journal of Peking Union Medical College Hospital

摘　　要：目的观察麻醉诱导前静脉预注维库溴铵对芬太尼诱发咳嗽(fentanyl-induced cough,FIC)的抑制效果。方法 160例患者随机分为两组,对照组静脉注射生理盐水1ml;维库溴铵预注组静脉注射维库溴铵0.01mg/kg,均采用左侧肘正中静脉注射;两组均于5min后静脉注射芬太尼3μg/kg,注射时间2s。记录两组患者咳嗽发生的次数和出现时间,并根据咳嗽发生次数进行严重程度分级。在注射生理盐水或维库溴铵时、注射芬太尼时及注射后1、2min分别记录血压、心率、呼吸和脉搏血氧饱和度及药物不良反应。结果两组患者性别构成差异无统计学意义(P=0.081)。两组比较,维库溴铵组芬太尼诱发咳嗽的发生率(21.3%,17/80)明显低于对照组(42.5%,34/80)(P=0.004);维库溴铵组芬太尼诱发中度和重度咳嗽患者为35.3%(6/17),明显少于对照组的55.9%(19/34)(P<0.005);咳嗽出现时间和血流动力学参数比较两组差异无统计学意义。结论维库溴铵预处理能有效降低芬太尼诱发咳嗽的发生率和强度。Objective To observe the effect of intravenous vecuronium pretreatment on fentanyl-induced cough （FIC）. Methods Totally 160 American Society of Anesthesiologists class I - II patients, aged 18-65 years within normal weight, scheduled for elective surgery, were randomly assigned to receive intravenous vecuronium 0.01 mg/kg （pretreatment group） or placebo （normal saline, control group） 5 minutes prior to the administration of fentanyl 3 ug/kg in a randomized and double-blind fashion. Any episode of cough was classified as coughing, and graded as mild （1-2） , moderate （3-4） , or severe （5 or more）. We recorded the timing and severity of cough and monitored the vital signs and discomforts such as dizziness, tinnitus, nausea/vomiting, apnea, and dysrhythmia. Results The gender distribution showed no significant difference between two groups （P =0. 081 ）. The incidence of cough was 21.3% （17/80） in pretreatment group and 42.5% （34/ 80 ） in control group （ P = 0. 004）. The incidence of moderate and severe cough was significantly higher in the control group （ 19/34, 55.9% ） than in pretreatment group （6/17, 35.3% ） （ P 〈 0. 005 ）. There was no significant difference between these two groups in the timing of cough. Vital signs were stable in both groups and no difference was shown in discomforts. Conclusion Vecuronium pretreatment can effectively reduce the incidence and severity of FIC.

关 键 词：芬太尼 咳嗽 维库溴铵 预注法 

分 类 号：R614.1[医药卫生—麻醉学]