芬太尼诱发咳嗽在预测术后恶心呕吐中的意义  

Significance of fentanyl-induced cough in predicting the postoperative nausea and vomiting

作　　者：贾秀男 王虹丹 马雯 张媛 王吨卫[1] 韩伟[1] JIA Xiu-nan;WANG Hong-dan;MA Wen;ZHANG Yuan;WANG Dun-wei;HAN Wei(Department of Anesthesiology,the First Bethune Hospital of Jilin University,Changchun 130000,China)

机构地区：[1]吉林大学白求恩第一医院麻醉科,长春130000

出　　处：《实用药物与临床》2018年第10期1177-1179,共3页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨芬太尼注射后诱发的咳嗽(FIC)是否为术后恶心呕吐(PONV)发生的一项危险因素。方法全身麻醉下行宫腔镜手术的女性患者360例,麻醉诱导采用咪达唑仑0.05 mg/kg、芬太尼3μg/kg在5 s内注射,芬太尼注射后观察1 min,再给予顺阿曲库铵0.15 mg/kg、丙泊酚1.5 mg/kg顺序给药,记录注射芬太尼1min内患者出现咳嗽的发生情况,术后由另一位麻醉医生记录术后患者24 h内恶心呕吐的发生率,根据芬太尼诱导后是否出现咳嗽,将患者分为有呛咳组和无呛咳组。结果两组患者的年龄、BMI、手术时间、芬太尼总量、ASA分级比较差异无统计学意义(P> 0.05)。FIC组PONV发生率高于无FIC组(32.7%vs.18.3%,P=0.004)。结论FIC是可预测PONV的危险因素。Objective To explore the correlation between fentanyl-induced cough （FIC） and postoperative nausea and vomiting （ PONV ） during the induction of general anesthesia. Methods Totally 360 female patients undergoing hysteroscopic surgery under general anesthesia were induced with midazolam 0. 05 mg/kg and fentanyl 3 μg/kg injection within 5 s, and then cisalracurium 0. 15 mg/kg and propofol 1.5 mg/kg were administered sequentially after observation of 1 min. The incidence of cough in patients who were given fentanyl during the induction period was recorded,and the occurrence of nausea and vomiting within 24 h after surgery was observed by another anesthesiologist. Patients were divided into FIC group and non-FIC group according to whether the fentanyl-induced cough occurred. Results There was no significant difference in age, BMI, operative time, total amount of fentanyl or ASA grade between the two groups（P 〉 0. 05 ）. The incidence of PONV in FIC group was higher than that in non-FIC group （32. 7% vs. 18.3% ,P =0. 004）. Conclusion FIC is a predictable risk factor for PONV.

关 键 词：芬太尼 咳嗽 术后恶心呕吐 宫腔镜手术 全身麻醉 

分 类 号：R614[医药卫生—麻醉学]