预注不同剂量右美托咪定对芬太尼诱导呛咳反应的影响  

Effect of dexmedetomidine pretreatment on suppressing fentanyl induced cough

作　　者：范译方[1] 姜凤鸣[2] 朱磊[1] 杜奕鹏[1] 李春萍[1] 

机构地区：[1]吉林大学第一医院麻醉科,长春市130021 [2]吉林大学第一医院泌尿外一科,长春市130021

出　　处：《临床麻醉学杂志》2013年第9期879-881,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察预注不同剂量的右美托咪定对芬太尼诱导呛咳反应(FIC)的影响。方法选择190例择期手术的患者,随机分为右美托咪定0.2μg/kg组(D1组,n=63)、右美托咪定0.5μg/kg组(D2组,n=64)和对照组(C组,n=63),分别在麻醉诱导前静脉泵注右美托咪定0.2μg/kg、右美托咪定0.5μg/kg和生理盐水20ml,然后在2s内注入芬太尼4μg/kg。记录芬太尼注射后1min内FIC发生率及发生时间;观察给药前(T0)及给药后10min(T1)、芬太尼注射后1min(T2)的HR、SBP、DBP和警觉/镇静评分(OAA/S评分)。结果与C组比较,D1组和D2组FIC发生率明显降低(P<0.05);D1组与D2组FIC发生率差异无统计学意义,三组FIC发生时间差异无统计学意义。与T0时比较,T1、T2时D2组HR明显减慢、SBP、DBP明显降低(P<0.05)。与D1组比较,T1、T2时D2组HR明显减慢(P<0.01),SBP、DBP差异无统计学意义。与C组比较,T1、T2时D2组HR明显减慢、SBP、DBP明显降低(P<0.05)。不同时点三组OAA/S评分差异无统计学意义。结论右美托咪定0.2μg/kg及0.5μg/kg均能够明显抑制芬太尼诱导的呛咳反射,但与右美托咪定的镇静作用无关。Objective To observe the effect of different doses of dexmedetomidine on fentanyl induced cough reflex. Methods A total of one hundred and ninety patients undergoing elective operation were randomly divided into group dexmedetomidine 0. 2μg/kg group （group D1, n=63）, group dexmedetomidine 0.5 μg/kg （group D2, n= 64） and control group （group C, n= 63）, respectively. Before anesthesia induction, intravenous infusion of dexmedetomidine 0.2 μg/kg, dexmedetomidine 0.5μg/kg and saline, then fentanyl 4 μg/kg was injected in 2s. Cough frequency and onset time 1 min after injection and heart rate, systolic pressure, diastolic pressure, the observer＇s assessment of AlertnessSedation prior to dexmedetomidine or saline injection （T0） and 10 minn after the injection （T1）, 1 min after fentanyl injection （T2） were recorded. Results Compared with the group C, the incidence of cough of group D1 and group D2, was significantly reduced （P〈 0.05）, but the onset time of cough was no significant difference. There was no significant difference about the incidence of cough between group D1 and group D2. In group D2, HR, SBP, DBP at T1 , T2 and To significantly decreased （P〈0. 05） ; at the T1 and T2. HR, SBP, DBP of D2 group were significantly lower than those in the group C, the difference was statistically significant （P〈0.01）, HR in the group D2 at T1, T2 decreased compared with the group D1, the difference was statistically significant （P〈0. 01）. The OAA/S score of groups D1, D2 and C at To, T1, T2 was no statistically different. Conclusion Dexmetomidine 0. 2 μg/kg and 0. 5 μg/kg could significantly inhibit the fentanyl induced cough, and it has nothing to do with the sedative effects.

关 键 词：右美托咪定 芬太尼 芬太尼诱导呛咳反应 临床分析 

分 类 号：R614[医药卫生—麻醉学]