布托啡诺两种给药途径对舒芬太尼诱发呛咳反射的影响  

Effect of two Butorphanol administration routes on cough reflex induced by Sufentanil

作　　者：薛晓丽 王菁[1] 张龙新[1] 周敏[1] 陈文华 XUE Xiaoli;WANG Jing;ZHANG Longxin;ZHOU Min;CHEN Wenhua(Department of Anesthesiology,Fujian Provincial Maternity and Children Hospital,Fujian Province,Fuzhou350001,China)

机构地区：[1]福建省妇幼保健院麻醉科,福建福州350001

出　　处：《中国当代医药》2022年第34期156-160,共5页China Modern Medicine

摘　　要：目的观察诱导前通过鼻腔和静脉两种途径给予布托啡诺对舒芬太尼诱发呛咳反射的影响。方法选取2018年8月至11月的福建医科大学附属协和医院乳腺外科的120例择期行乳腺癌改良根治术的患者作为研究对象,采用随机数字表法将其分为布托啡诺鼻腔给药组(N组)、布托啡诺静脉给药组(V组)和盐水对照组(S组)(n=40)。N组在麻醉诱导前20 min:经鼻给予布托啡诺1 mg,在麻醉诱导前5 min,经静脉注射生理盐水1 ml。V组在麻醉诱导前20 min:经鼻给予生理盐水1 ml,在麻醉诱导前5 min,经静脉注射布托啡诺1 mg。S组在麻醉诱导前20 min:经鼻给予生理盐水1 ml,在麻醉诱导前5 min,经静脉注射生理盐水1 ml。比较三组患者呛咳反射的发生率、呛咳的严重程度以及血流动力学指标和不良反应等。结果N组及V组呛咳的发生率、呛咳的严重程度均低于S组,差异有统计学意义(P<0.017);而N组和V组比较,差异无统计学意义(P>0.017)。三组T_(1)~T_(7)时的平均动脉压(MAP)、心率(HR)比较,差异均无统计学意义(P>0.05);而V组T_(5)、T_(6)时脉搏血氧饱和度(SpO_(2))低于N组及S组,差异有统计学意义(P<0.05);其他几个时间点比较,差异无统计学意义(P>0.05);V组在T_(5)、T_(6)时MAP高于T_(3)时,差异有统计学意义(P<0.05);V组T6时HR高于T_(2)、T_(3)时,差异有统计学意义(P<0.05);V组T_(4)、T_(5)、T_(6)时SpO_(2)低于T_(0)时,差异有统计学意义(P<0.05)。V组呼吸抑制、头晕的发生率高于N组及S组,差异有统计学意义(P<0.017)。结论1 mg布托啡诺能有效抑制全麻诱导期间舒芬太尼引起的呛咳反射,鼻腔给药血流动力学更稳定且不良反应较少,更具优势。Objective To observe the effects of Butorphanol premedication by nasal delivery and intravenous injection on sufentanil-induced cough before the induction of anesthesia and preemptive analgesia.Methods A total of 120 patients undergoing modified radical mastectomy under general anesthesia in Breast Surgery of Fujian Medical University Union Hospital from August to November 2018 were divided into nasally delivered Butorphanol group(group N),intravenously injected Butorphanol group(group V)and normal saline group(group S)by random number table method.Group N and V were respectively given 1 mg of Butorphanol by different ways before anesthesia induction,while group S was given 1 ml of normal saline.The incidence and intensity of cough,hemodynamic indexes and side effects were compared among the three groups.Results The incidence and intensity of cough in group N and group V were lower than those in group S,and the differences were statistically significant(P<0.017).There was no significant difference between group N and group V(P>0.017).There were no significant differences in mean pressure(MAP)and heart rate(HR)between the three groups at T_(1)-T_(7)(P>0.05).At T_(5) and T_(6),pulse oxygen saturation(SpO_(2))of group V was lower than that of group N and group S,and the difference was statistically significant(P<0.05),and there was no significant difference in other time points(P>0.05).At T_(5) and T_(6),MAP of group V was higher than that at T_(3),and the difference was statistically significant(P<0.05).At T_(6),HR in group V was higher than that at T_(2) and T_(3),and the difference was statistically significant(P<0.05).At T_(4),T_(5) and T_(6),SpO_(2) of group V was lower than that at T_(0),and the difference was statistically significant(P<0.05).The incidence of respiratory depression and dizziness in group V was higher than that in group N and group S,and the difference was statistically significant(P<0.017).Conclusion The sufentanil-induced cough could be effectively inhibited by 1 mg of Butorphanol premedicat

关 键 词：布托啡诺 舒芬太尼 呛咳反射 呼吸抑制 

分 类 号：R614[医药卫生—麻醉学]