地塞米松和利多卡因抑制舒芬太尼全麻诱导时诱发呛咳的临床疗效观察  

Comparison of the Inhibitory Effect of Dexamethasone and Lidocaine on Sufentanil Anesthesia Induced Cough

作　　者：王锦媛[1] 侯清武 马玉英[2] 

机构地区：[1]石河子大学医学院,新疆石河子市832000 [2]新疆石河子大学医学院第一附属医院急诊科

出　　处：《中国全科医学》2014年第30期3620-3622,共3页Chinese General Practice

摘　　要：目的对比地塞米松和利多卡因在全麻诱导时降低舒芬太尼诱发呛咳的疗效,探讨舒芬太尼诱发呛咳的可能机制。方法选取2013年1—8月在新疆石河子大学第一附属医院择期行舒芬太尼诱导全麻手术的患者120例,采用随机数字表法分为3组,每组40例。对照组(Ⅰ组)静脉注射0.9%氯化钠溶液5 ml;地塞米松组(Ⅱ组)静脉注射地塞米松5 mg;利多卡因组(Ⅲ组)静脉注射利多卡因0.5 mg/kg,总量均在5 ml,5 s内注射完毕。观察舒芬太尼诱导后呛咳反应的发生率和严重程度,记录血压、心率的变化。结果与Ⅰ组比较,Ⅱ组、Ⅲ组呛咳反应严重程度降低(P<0.05);Ⅱ组和Ⅲ组间比较无差异(P>0.05)。Ⅰ组、Ⅱ组、Ⅲ组在用药前后、呛咳前后均可见血压和心率波动,但3组各组内在给药时(T0)、给药后3 min(T1)、插管后1 min(T2)、插管后3 min(T3)各时间点的血压、心率比较无差异(P>0.05)。结论地塞米松和利多卡因均可降低全麻诱导期舒芬太尼诱发的呛咳反应,但舒芬太尼作用机制尚不明确。Objective To compare the inhibitory effect of dexamethasone and lidocaine on sufentanil induced cough in general anesthesia,and to discuss the possible mechanism of sufentanil caused cough. Methods 120 patients with general anesthesia in the First Affiliated Hospital of Shihezi University School of Medicine form January to August in 2013 were randomly divided into 3 group,40 cases in each group. Control group（ groupⅠ,given injection of 5 ml 0. 9% sodium chloride solution）,dexamethasone group（ groupⅡ,given injection of 5 mg intravenous dexamethasone） and lidocaine group（ group Ⅲ,given injection of lidocaine for 0. 5 mg /kg intravenously）. The total volume of injection was all 5 ml,and the injection was given within5 s. The incidence and severity of cough induced by sufentanil was observed,and the changes of blood pressure and heart rate were recorded. Results Compared with groupⅠ,the severity of cough in groupⅡ and group Ⅲ was reduced（ P〈0. 05）,and the severity between groupⅡ and group Ⅲ showed no statistically significant difference（ P〉0. 05）. All the three groups had fluctuations in mean arterial pressure and heart rate before and after general anesthesia and cough. Among the three groups,the mean arterial pressure and heart rate between each time point of T0,T1,T2 and T3 showed no statistically significant difference（ P〉0. 05）. Conclusion Dexamethasone and lidocaine can alleviate the cough induced by sufentanil in general anesthesia,but the mechanism of sufentanil is not clear.

关 键 词：地塞米松 利多卡因 舒芬太尼 全身麻醉 呛咳 

分 类 号：R971.2[医药卫生—药品]