盐酸纳美芬预防小儿全麻诱导期瑞芬太尼诱发呛咳的临床观察  

Nalmefene Hydrochloride Prevents the Choking Induced by Remifentanil for Induction of General Anesthesia in Children

作　　者：姜燕[1] 魏嵘[1] 傅月珍[1] 黄小静[2] JIANG Yan1,WE Rong1,FU Yuezhen1,HUANG Xiaojing2(1Department of Anesthesiology, Children＇s Hospital of Shanghai, Shanghai Jiao Tong University, Shanghai General Hospital, Shanghai 200062; 2Department of Anesthesiology,the First people＇s Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 20008)

机构地区：[1]上海市儿童医院上海交通大学附属儿童医院麻醉科,上海200062 [2]上海交通大学附属第一人民医院麻醉科,上海200080

出　　处：《药学与临床研究》2018年第4期305-307,共3页Pharmaceutical and Clinical Research

摘　　要：随机选择小儿阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者120例,分为4组:盐酸纳美芬组(N1、N2、N3组)及对照组(C组),各30例。在麻醉诱导时静脉分别注射盐酸纳美芬0.25μg·kg^(-1)、0.20μg·kg^(-1)和0.15μg·kg^(-1)和0.9%氯化钠注射液,观察4组患者静脉注射瑞芬太尼1min内发生呛咳的次数和程度及其对插管过程患者血流动力学的影响。研究发现呛咳发生率为N1<N2<N3<C组(P<0.05),N1、N2组诱导期间的生命体征更平稳(P<0.05)。提示预防性注射0.20μg·kg^(-1)纳美芬即可有效减少瑞芬太尼麻醉诱导期患者呛咳反应的发生率和呛咳的程度,且血流动力学更加稳定。A total of 120 children with obstructive sleep apnea-hypopnea syndrome（OSAHS） undergoing the surgrey were randomly divided into 4 groups,nalmefene hydrochloride groups（N1,N2 and N3 groups） and control group（C group）,30 in each group.Nalmefene hydrochloride（0.25 μg·kg^-1,0.20 μg·kg^-1 and 0.15 μg·kg^-1）were used before the induction of anesthesia respectively in N1,N2 and N3 groups,and 0.9% sodium chloride was used before the induction of anesthesia in C group.The occurrence and frequency of cough in 1 min after intravenous injection of remifentanil were observed,and the corresponding influence on the hemodynamics of patients during intubation was observed.We found that the incidence of cough was N1N2N3C（P〈0.05）,and the vital signs in the N1 and N2 group during induction were more stable than in the N3 group（P〈0.05）.These results suggest that the prophylactic injection of nalmefene 0.20 μg·kg^-1 before induction can effectively reduce the incidence and degree of remifentanil-induced cough in children with stable hemodynamics.

关 键 词：盐酸纳美芬 呛咳 小儿 瑞芬太尼 

分 类 号：R969.4[医药卫生—药理学]