摘要
目的:观察和评价利多卡因或麻黄素抑制芬太尼引起咳嗽的效能。方法:105例拟行全麻患者,ASAⅠ～Ⅱ级,18～65岁,男女兼有。随机分为3组,每组35例。Ⅰ组:生理盐水(对照);Ⅱ组:利多卡因1mg/kg;Ⅲ组:麻黄素5mg。3组分别在10～15s内静脉匀速注入。1min后分别静脉给予芬太尼3μg/kg。记录注射麻黄素或利多卡因后1min,芬太尼后1min(继之常规全麻诱导气管插管)、2min内出现的咳嗽反应和心血管变化。结果:Ⅰ、Ⅱ、Ⅲ组咳嗽发生率分别达62.9%,37.1%,11.4%;Ⅱ、Ⅲ组分别比Ⅰ组咳嗽显著减少P<0.05和P<0.01。Ⅱ、Ⅲ组间比较也有统计学差异P<0.05。3组间不同时间段血压和心率分别与用药前基础值比较:Ⅰ组SBP和HR在芬太尼后2min时分别明显下降(P<0.01);Ⅱ组仅SBP在此时有明显下降(P<0.05),其它不同时间段SBP和HR无统计学差异P>0.05。Ⅲ组在麻黄素后SBP和HR分别P<0.05(即SBP平均增加7.3mmHg,HR平均增快6.7次/min),未见其它毒副作用发生。结论:静脉小剂量利多卡因或麻黄素具有明显预防或抑制芬太尼引起的咳嗽反射;有效率分别达62.9%和88.6%,此方法安全有效,方便易行,为临床抑制芬太尼引起的咳嗽反射提供了良好的选择。
Objective. To evaluate the effectiveness of lidocaine or ephedrine in preventing fentanyl-induced cough. Methods. 105 patients requiring general anaesthesia were randomly allocated into three groups and. the following medications were given intravenously：Group Ⅰ（n=35） received normal saline 5ml, Group Ⅱ（n =35） received lidocaine lrng/ kg, Group Ⅲ（n=35） received ephedrine 5mg. At one minute after injection, fentanyl 3μg/kg was given intravenously within three seconds. The occurrence of cough and vital sign profiles were recorded within two minutes after injection of fentanyl was given. Results： 62. 9% of patients in the placebo group had cough, whereas the frequency was significantly decreased in Groups Ⅱ （37. 1%） and Ⅲ （11. 4%）. Patients in Group Ⅲ showed an increase in SBP and HR measurements （7.3mmHg and 6. 7 beats/min vs baseline）. Conclusion： Intravenous lidocaine lmg/kg or ephedrine 5 mg was effective in preventing fentanyl induced cough. The results provide a convenient method to decrease fentanyl-induced cough.
出处
《医学理论与实践》
2009年第2期135-137,共3页
The Journal of Medical Theory and Practice
关键词
利多卡因
麻黄素
预防
芬太尼
咳嗽
Lidocaine, Ephedrine, Preventing, Fentanyl, Coughing
