预注小剂量顺阿曲库铵对芬太尼诱发呛咳反应的影响  

Effect of priming with cisatracurium on fentanyl-induced cough

作　　者：周乐顺[1] 欧珊[1] 白树荣[1] 冉茂荣[1] 林露[1] 

机构地区：[1]成都军区总医院麻醉科,四川成都610083

出　　处：《四川医学》2013年第4期475-476,共2页Sichuan Medical Journal

摘　　要：目的观察预注小剂量顺苯磺酸阿曲库铵对芬太尼诱发的呛咳反应的影响。方法择期行全麻手术患者80例,ASAⅠ或Ⅱ级,随机分为两组,每组40例,Ⅰ组全麻诱导顺序为静脉注射力月西0.04mg/kg、顺苯磺酸阿曲库铵0.05mg/kg,3min后静注芬太尼3μg/kg,速度为3s,1min后静注丙泊酚1.5mg/kg、顺苯磺酸阿曲库铵0.15mg/kg进行气管内插管、机械通气;Ⅱ组麻醉诱导用药为力月西0.04mg/kg、芬太尼3μg/kg注射速度3s,1min后静注丙泊酚1.5mg/kg、顺苯磺酸阿曲库铵0.2mg/kg,气管插管、机械通气。观察芬太尼注射后1min内咳嗽情况及肌松药的起效时间。结果Ⅰ组芬太尼诱发的呛咳反应发生率为7.5%,Ⅱ组为30%,咳嗽程度Ⅰ组轻于Ⅱ组(P<0.01);肌松药起效时间Ⅰ组为152s,Ⅱ组为174s,两组比较差异有统计学意义(P<0.05)。结论预注小剂量顺苯磺酸阿曲库铵既可以缩短肌松药的起效时间又可以预防及减轻芬太尼诱发的呛咳反应。Objective To investigate the effect of pretreated with low dose cisatracurium besylate during anesthesia induction on fentanyl-induced cough. Methods Eighty ASA I or I1 patients undergoing scheduled operation under general anesthesia were randomly divided into two groups （n = 40） ：experimental group （group I ）and control group （group II ）. Group I which was induced with successive intravenous injection of midazolam 0.04mg/kg, cisatracurium 0. 05mg/kg and 3minutes later fentanyl 3μg/kg was given ,then propofol 1.5mg/kg and cisatracurium 0. 15 mg/kg were given. Group II which was received intravenous injection of midazolam 0. 04mg/kg ,fentanyl 3pLg/kg over 3s and propofol 1.5mg/kg , cisatracurium 0. 2mg/kg respectively. When TOF value reached 0 endotracheal intubation was performed. The incidence and degree of cough were recorded in 1 minute after injecting with fentanyl. Results The incidence of cough was 7. 5 % in group I , which was significantly lower than 30% in group II（P 〈0. 01 ）. Compared with group II ,the severity of cough was decreased in group I（P 〈0.01 ）. The onset time of cisatracurium is 152s vs 174s in group I and II （P 〈 0. 05）. Conclusion Priming with cisatracurium can be used to accelerate the onset time＇,also be used to prevent fentanyl-induced.cough during anesthesia induction.

关 键 词：芬太尼 咳嗽 顺苯磺酸阿曲库铵 

分 类 号：R614.2[医药卫生—麻醉学]