摘要
目的探讨异丙托溴铵对全身麻醉诱导期舒芬太尼诱发呛咳的预防效果。方法选取2022年6月至2024年9月该院收治的全身麻醉下行择期手术的201例患者作为研究对象,将患者分为异丙托溴铵组(P组,n=100)和生理盐水组(C组,n=101)。P组和C组患者在全身麻醉诱导前30 min由专门的麻醉护士分别经口给予异丙托溴铵吸入气雾剂2揿(以C_(20)H_(30)BrNO_(3)·H_(2)O计42μg)和0.9%生理性盐水喷雾剂2喷。麻醉医生在5 s内静脉注射舒芬太尼0.5μg/kg,3 min后静脉注射丙泊酚2 mg/kg、罗库溴铵0.6 mg/kg,达到满意肌肉松弛效果后使用可视喉镜进行气管插管。记录舒芬太尼给药后1 min内呛咳的发生情况。分别记录不同时间点患者的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_(2))。结果舒芬太尼给药后1 min内P组重度呛咳和呛咳合计发生率低于C组,差异有统计学意义(P<0.05)。两组患者不同时间点的HR、MAP及SpO_(2)比较,差异无统计学意义(P>0.05)。两组患者均未发生恶心、呕吐、心律失常等不良反应。结论在麻醉诱导前30 min气雾吸入异丙托溴铵可有效减少舒芬太尼静脉注射诱发的呛咳,降低重度呛咳发生率。
Objective To investigate the preventive effect of ipratropium bromide on sufentanil-induced cough during general anesthesia induction.Methods A total of 201 patients undergoing elective surgery under general anesthesia from June 2022 to September 2024 were selected and divided into the ipratropium bromide group(group P,n=100)and the normal saline group(group C,n=101).Thirty minutes before anesthesia induction,group P and group C received oral administration of ipratropium bromide inhalation aerosol(2 puffs,equivalent to 42μg C_(20)H_(30)BrNO_(3)·H_(2)O)and 0.9%normal saline spray(2 puffs),respectively.Anesthesiologists intravenously administered sufentanil(0.5μg/kg)within 5 seconds,followed by propofol(2 mg/kg)and rocuronium(0.6 mg/kg)after 3 minutes.Endotracheal intubation was performed using a videolaryngoscope after achieving satisfactory muscle relaxation.The occurrence of cough within 1 minute after sufentanil administration was recorded.Heart rate(HR),mean arterial pressure(MAP),and pulse oxygen saturation(SpO_(2))were measured at different time points.Results Within 1 min after sufentanil administration,the incidence of severe cough and total cough in group P was significantly lower than that in group C(P<0.05).There was no significant difference in HR,MAP,or SpO_(2) between the two groups at different times(P>0.05).No adverse reactions such as nausea,vomiting,or arrhythmia occurred in either group.Conclusion Inhaling ipratropium bromide 30 min before anesthesia induction could effectively reduce sufentanil-induced cough and decrease the incidence of severe cough.
作者
李高杰
徐姝珺
韩甜甜
张振
LI Gaojie;XU Shujun;HAN Tiantian;ZHANG Zhen(Department of Anesthesiology,Xiangyang No.1 People’s Hospital,Hubei University of Medicine,Xiangyang,Hubei 441100,China)
出处
《重庆医学》
2025年第8期1816-1819,共4页
Chongqing Medical Journal
基金
湖北省卫生健康委员会科研基金指导性项目(WJ2023F078)
湖北省襄阳市科学技术局科技计划面上项目(2022YL29A)
湖北省襄阳市第一人民医院研究生导师科研指导能力提升项目(XYY2023SD21)。
