布托啡诺预防芬太尼诱发呛咳反应的效果  

The effect of butorphanol to prevent the choking response induced by fentanyl

作　　者：曹为标 甄中华 邵东华 郑永锋 CAO Wei-Biao;ZHEN Zhong-Hua;SHAO Dong-Hua(Department of Anesthesiology,the First People's Hospital of Zhenjiang City,Zhenjiang 212002,Jiangsu,China)

机构地区：[1]镇江市第一人民医院麻醉科,江苏镇江212002

出　　处：《吉林医学》2024年第5期1143-1145,共3页Jilin Medical Journal

基　　金：镇江市社会发展指导性科技计划项目[项目编号:FZ2022095]。

摘　　要：目的:探讨布托啡诺静脉注射抑制芬太尼呛咳反应的临床价值。方法:选取镇江市第一人民医院2022年5月~2023年3月择期行全身麻醉的患者80例为研究对象,美国麻醉医师协会(ASA)分级Ⅰ~Ⅱ级,年龄18~70岁,体重40~90 kg,采用随机数字法均分为两组,每组40例。C组(对照组):麻醉诱导前静脉给予0.9%生理盐水(NS)5 ml;B组(试验组):麻醉诱导前静脉给予布托啡诺20μg/kg(0.9%NS稀释至5 ml)。3 min后静脉给予芬太尼5μg/kg(注射时间为3 s)。记录芬太尼给予后2 min内诱发的呛咳发生率,呛咳严重程度(轻度1~2次,中度3~4次,重度5次及以上)及相关不良反应;观察0.9%NS及布托啡诺注射前(T0)、注射后3 min(T1)、芬太尼注射后2 min(T2)时平均动脉压(MAP)及心率(HR)的变化。结果:与C组相比,B组呛咳发生率明显降低,差异有统计学意义(P<0.05);B组呛咳严重程度明显低于C组,差异有统计学意义(P<0.05)。不同时点两组MAP及HR组间组内差异无统计学意义(P>0.05)。结论:20μg/kg布托啡诺可有效预防全身麻醉诱导期芬太尼诱发的呛咳反应,尤其对中、重度呛咳有明显抑制效果,且未出现药物相关不良反应。Objective To investigate the clinical value of intravenous butorphanol to inhibit the choking response to fentanyl.Method 80 patients undergoing elective general anesthesia in our hospital were selected as the study subjects from May 2022 to March 2023,with ASA classⅠ~Ⅱ,aged 18~70 years,weight 40~90 kg,and were divided equally into two groups using the random number method,each with 40 cases.Group C(control group):0.9%NS 5 ml was given intravenously before induction of anesthesia;Group B(experimental group):bupropion 20μg/kg(0.9%NS diluted to 5 ml)was given intravenously before induction of anesthesia.5μg/kg of fentanyl was given intravenously 3 min later(injection time was 3 s).The incidence of choking induced within 2 min after fentanyl administration,the severity of choking(1~2 times for mild,3~4 times for moderate,5 times and above for severe),and related adverse effects were recorded;the changes of MAP and HR were observed before(T0),3 min after(T1)and 2 min after(T2)fentanyl injection for 0.9%NS and bupropion.Results Compared with group C,the incidence of choking was significantly lower in group B(P<0.05);the severity of choking was significantly lower in group B than in group C(P<0.05).There was no statistically significant intra-group difference in MAP and HR between the two groups at different time points(P>0.05).Conclusion 20μg/kg butorphanol can effectively prevent fentanyl-induced choking response during induction of general anesthesia,especially for moderate and severe choking,and there were no drug-related adverse effects.

关 键 词：芬太尼 布托啡诺 呛咳反应 全身麻醉 

分 类 号：R971[医药卫生—药品]